Meetings of working groups
By the end of April, 11 working groups meetings took place. The main focus of CKS team is to provide standpoints towards feedback and set review of main DRG outputs. Furthermore, CKS team participated in 2 expert meetings with Natianal Health Service (NHS) and Narodowy Fundusz Zdrowia (NFZ) held under the auspices of the. European Commission.
The key topic for CKS is recalculation of relative weights which deadline keeps slightly changing due to various irregularities in DRG data and their poor quality for 2019. DRG data validation is still not completed.
While importing DRG data, various technical problems were identified, which will try to be solved by a new IT infrastructure before next year data collection.
While defining uniform coding method of hospitalised patients, various irregularities were identified. Suggested changes will be valid from 1 June 2021 after the approval by the working group and the management committee.
Economic team focused on updating the Calculation handbook and its attachments. The second meeting of working group of the cost calculation was held, in which suggestions concerning removal of COVID ward by creating a new group of cost centres were discussed.
Currently, it is in a phase of collecting stakeholders´ comments. CKS team is working on updates and addition of the chart of accounts for health care providers which is planned to be unified. Furthermore, we are preparing the list of direct costs which will be defined and added to the Calculation handbook.
In the beggining of May, the third meeting of working group will take place in which mentioned suggestions will be discussed. Moreover, suggestions obtained in feedback were analysed.
CKS DRG IT team continues to collect DRG data from health care providers even after the deadline of annual data submission. Several health care providers did not meet the deadline due to the various reasons such as accounting issues, deadline of filling tax return, missing employees that were responsible for creating mentioned data. Thus, CKS has postponed the deadline to 30 April 2021. By the date all data should be available. 66 hospitals have imported DRG data from 2020. A request for an extension of the deadline has been approved for 7 health care providers. Remaining 13 health care providers are awaiting the statement.
In the working group DATA, there will be defined a new methodological guidance, which will solve current data heterogenity. CKS ambition in collaboration with WG is to improve data quality to the maximal possible level. Currently, a huge group of data that will not be sucessfully validated needs to be removed. Based on approved changes in WG, this year's data will have higher quality.
CKS team continues on preparing complex methodology of data validation with data from 2019. 85 formal and content validation controls have been performed. 35 controls identified some irregularities. Most of error data was identified while controlling data in the medical procedures which is vyrified by data code lists. Moreover, quite a huge part of erroneous data was identified in the table of reimbursements and costs.
Medical team held 7 working group meetings that focused on feedback analysis and prepared various methodologies and reviews that are described below.
The DRG Catalogue
In April, another meeting of the working group of the DRG Catalogue was held, in which an important result was obtained. It suggests to add methodology of suplementary remuneration into the methodology of recalculation of relative values.
CKS will be working on the given methodology during following weeks together with feedback analysis as well as analysis that is needed for specification of various parametres into the methodology of recalculation of relative weights.
The Definition handbook
CKS team focuses on feedback analysis and its compilement. Meeting of a working group of the Definition handbook (WG DH) was held in which plan for revision of the Definition handbook for 2021 was introduced.
There was a training focused on functioning and operating of Pflegetool that creates the Definition handbook. CKS team wants to especially thank our colleague Mrs. Pipíšková from the Health Care Surveillance Authority.
Compiled proposal for coding COVID-19 was introduced to the working group of methodological guidance and coding rules (WG MGCR) which is currently in a commenting phase.
Picture 1: Types of hospitalisation cases according to the reason of admission and positive COVID-19 cases; and overview of possible coding of clinical situations concerning COVID-19
The List of medical procedures
In April, feedback from health care providers was analysed. Processed suggestions are sent to experts to obtain their standpoints. Approved suggestions will be presented to a working group for the List of medical procedures.
WG LMP begun to set up the process of revision. The most number of procedures were coded to proficiency 1 - internal medicine and 10 - surgery. We chose procedures that were common for both proficencies and from them significant codes. 1 169 codes of procedures from LMP were obtained. These codes are in the review process (in search for duplicates, non-specified procedures etc.). CKS asked 14 specialised institutes to split the procedures between them. The goal was to introduce a way which can be used to perform the revision to experts. Revision is planned for the beginning of summer.
CKS DRG team