MOTIVATION Differential co-expression analysis (DCEA) has emerged in recent years as a novel, systematic investigation into gene expression data. While most DCEA studies or tools focus on the co-expression relationships among genes, some are developing a potentially more promising research domain, differential regulation analysis (DRA). In our previously proposed R package DCGL v1.0, we provide...

In order to facilitate effective clinical coding and hence the precise financial reimbursement of acute services, in 2005 Western District Health Service (WDHS) (located in regional Victoria, Australia) undertook a provisional coding trial for inpatient medical episodes to determine the magnitude and accuracy of clinical documentation. Utilising clinical coding software installed on a laptop co...

We use the introduction of diagnosis related groups (DRGs) in German neonatology to study the determinants of upcoding. Since 2003, reimbursement is based inter alia on birth weight, with substantial discontinuities at eight thresholds. These discontinuities create incentives to upcode preterm infants into classes of lower birth weight. Using data from the German birth statistics 1996-2010 and ...

Introduction Over the past four to five years, the focus in casemix-based payment systems in the United States has shifted more and more towards "value-based-purchasing" and "payfor-performance" measures. The reporting of pre-set quality indicators is now fundamentally in place for both the inpatient prospective-payment system, based on Medicare-Severity Diagnosis Related Groups (MS-DRGs), and,...

This study investigated various factors explaining the technical, allocative and cost efficiency of Finnish hospitals using parametric frontier models and nonparametric DEA models. DEA scores were correlated to the same set of variables as efficiency scores by stochastic frontier models. Specialization, specialization in expensive DRGs, sufficiently high proportion of resident physicians and in...

This article briefly relates the experience of a clinical coder working in the private healthcare sector in the Australian state of New South Wales and questions whether it is possible to work in this environment while adhering to the Clinical Coders' Creed. Private facilities in Australia that handle acute, psychiatric, respite and rehabilitation cases, rely mainly upon health insurance funds ...

This paper discusses a study conducted to identify factors that contributed to increased length of stay for two diagnosis related groups (DRGs) and their consequential impact on nursing salaries. The study shows that three separate clusters of cost drivers (DRG-related, nurse-related, and patient-related) contributed to increased length of stay for DRG 177 (chronic obstructive airways disease) ...

BACKGROUND In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of this study is to describe the relationship between timing of radiological interventions, in particu...

The Diagnosis-Related Groups (DRGs), is a method that identifies patients with similar resources use, based on statistical evaluation of hospital records. Statistics provide the Diagnosis related consumed resources and, thus, they enable the calculation of an average patient’s case-cost. On the basis of the Hospital activity levels and case mix, the health authorities can allocate the annual ho...

On October 1, 2013 the reporting of diagnoses and procedures in the U.S. will transition from the clinical modification of the ninth revision of the International Classification of Diseases (ICD-9-CM) to the tenth revision (ICD-10). The impact of conversion to ICD-10 on Medicare MS-DRG payments to hospitals was estimated using 2009 Medicare data. A minimal hospital payment increase of 0.05 perc...