First historical meetings
In March, 45th Meeting of the Management Committee (MC) was held. Historically, the first meeting in the Ministry of Health of the Slovak Republic was focused on reimbursment mechanisms and price regulations.
CKS has constituted 5 working groups (WG) (out of 7 working groups) to which the members of the Management Committee nominated its representatives and they started the collaboration to enhance Slovak DRG system. Members and recordings from WG meetings are available HERE.
Historically, I. DRG Conference in Slovakia was held on 23 March 2021 under the auspices of the secretary of state Peter Stachura. Due to the epidemiological situation it was held online and 200 particapants were present - representatives of the Hospitals Association, health insurance companies, specialised institutes as well as foreign experts from the European Commission and Institut für das Entgeltsystem im Krankenhaus. Recording of the conference is available HERE and individual presentations HERE.
CKS DRG team is pleasured to welcome 2 new colleagues: in economic department and administration of the Centre for the classification system, together with training department.
The deadline for evaluation of suggestions in DRG (Feedback) was till 16 March 2021.
175 suggestions were submitted, which will be the main concern of CKS (1 suggestion usually contains more requests). To date, 244 suggestions were submitted. All standpoints will be available HERE. CKS suggested uniform rules for evaluation of suggestions which have been introduced to working groups. Currently, the rules are in a commenting phase. Moreover, various analysis that are described below were performed.
It is important to note, that rules and guidance are not set uniformly, understood or obeyed by the DRG users. This results in significant deformation of correct functional DRG system.
In March CKS DRG team was granted an access to servers, in which DRG data are stored. The Health Care Surveillance Authority (HCSA) is still a server provider. CKS DRG team progressed in the area of validation methodology. Moreover, data validation begun to be processed according to given methodology, while inputs suggest unfilled general data. After complete data validation, health care providers will be asked to amend the data.
The first meeting of the working group concerned about DRG data was held. Members' suggestions as well as suggestions of external members will be presented at the soonest WG in the mid of April. WG members have a possibility to comment any suggestion of validation methodology. In the end of March, e-DRG portal for data submission by health care providers for 2020 begun to be prepared. To submit DRG data, please click HERE.
CKS DRG medical team focused on analysing suggestions obtained in feedback and on document preparation to MC, DRG conference and individual WGs. 3 WG - the DRG Catalogue (CLS), the Definition handbook (DH) and List of medical procedures (LMP), are still open. CKS introduced a methodology to members of WG, that is currently in a commenting phase. After Easter holiday, further meetings are planned to be held, in which given methodologies will be edited according to the comments and they will be approved and presented to MC. CKS is working on other methodologies which will be introduced soon.
The DRG Catalogue
The highest number of suggestions from feedback were about the change in relative weights, the lenght of stay and suplementory remuneration. To solve the issues, global recalculation of relative weights and length of stay will be performed in the near future. Basic methodology of recalculation of relative weights and lenght of stay is in a commenting phase. Moreover, a methodology for equilable addition and pricing of suplementory remuneration items is planned.
The Definition Handbook
CKS DRG focused on data collection and feedback analysis concerning the Definition handbook. Furthermore, CKS prepared criteria for evaluating and processing suggestions to feeback. These criteria were prepared by working group of the definition handbook (WG DH) and are currently in a commenting phase.
WG members were focused on the review of the Definition handbook, which will be executed this year. While suggested categories of main diagnosis that should undergo revision, we focused on those that contained the highest number of hospitalised cases (HC), the highest number of reimbursements. From estimated data, radio of paid costs which are between health care providers and HC were compared. A systematic review will be introduced by WG DH and consequently to MC.
Various ways of coding HC diagnosed with COVID-19 in foreign countries were compared. CKS DRG team is preparing a scheme of mentioned coding by WG Coding rules in order for data to be unified. We finalised a document which point is to conclude main functioning principles of Definition handbook. It is available HERE.
The List of medical procedures
The main focus of CKS DRG team was to find the most widely used parts of the list of medical procedures. To medical procedures, proficiency was added and the main concern was towards two most numbered proficiency: internal medicine (code of proficiency 1) and surgery (code of proficiency 10). These proficiencies use more than 6 000 codes from the list of medical procedures, out of which 2 900 codes are common for both proficencies.
Many complaints were meant towards the area of interventional radiology (IRA), which contains many issues - duplicite codes, incorrect specification, or missing codes for certain executed processes in hospitals.
In March a working group of the List of medical procedures (WG LMP) was constituted. In the first meeting, CKS presented criteria that will be applied for feedback suggestions in the future. Furthermore, WG LMP plans on discussing the review of LMP in which specialised companies are to be invited according to the areas of the LMP. Review should begin with the mentioned 2490 codes (the most frequently used and contained in 80 per cent of complaints).
A document that conclude main functioning principles of the List of medical procedures has been finalised.
CKS DRG team