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[DRGs in dermatology: quality of coding and the effects of case mix].

BACKGROUND
High-quality coding of patient clinical data is mandatory for an effective DRG classification to result in adequate allocation of funding for inpatient treatment. The aim of the study was to determine the effect of controlled documentation on patient clinical data and to ascertain the outcome of calculated DRG-based yields depending on higher coding quality of patient treatment.


PATIENTS AND METHODS
In a prospective study, 1914 patient clinical records from the Department of Dermatology, University of Muenster, were captured using different documentation standards and the data was analysed. Grouping was performed on the basis of the Australian Refined DRG system v4.1. Dermatological patients were broken down into eleven groups based on principle diagnosis.


RESULTS
As a result of a controlled documentation, case mix, case mix index and patient clinical complexity level (PCCL) value were increased within identical samples. Furthermore, it was shown that high-quality coding may result in exact and reasonable classification of patient clinical data.


CONCLUSIONS
Different documentation standards may cause undesired effects on the monetary yields of in-patient treatment. It appears that high-quality coding and controlled documentation may guarantee adequate yields. FauIty. incomplete and (up)coding could be a potential economic risk for hospitals.