Biomedical subjects
Publications and source records attributed to R L Mullin.
The ICD-10 Procedure Coding System (ICD-10-PCS) has been developed as a replacement for Volume 3 of ICD-9-CM. This article will describe the development and structure of ICD-10-PCS--as well as describe the modifications that have been made to the system as a result of extensive review and testing.
The Diagnosis Related Groups patient classification scheme coupled with desk top PC technology permits sophisticated analysis of patient medical data. Individuals with no programming knowledge can produce sophisticated analysis. The functionality and structure of the 3M Analytical Workstation are described and example analysis reports are presented.
The Ambulatory Patient Group (APGs) are a patient classification system that was developed to be used as the basis of a prospective payment system (PPS) for the facility costs of outpatient care. This article will review the key characteristics of a patient classification system for ambulatory care, describe the APG development process, and describe a payment model based on the APGs. We present the results of simulating the use of APGs in a prospective payment system, and conclude with a discussion of the implementation issues associated with an outpatient PPS.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Medicare uses Diagnosis-related Groups for prospective hospital payments nationwide, but the groups were not originally intended as such. The authors trace the development of this landmark program and explore the concept of product line management. Dr. Fetter, a leading authority in health care resource allocation, developed the entire framework for DRGs as a method to predict hospital resource requirements. He is currently extending the DRG concepts to outpatient and long-term care facilities. This article is adapted from Dr. Fetter's presentation at the Bridgeport Symposium entitled "Performance Requirements for Clinical Laboratories Under Prospective Reimbursement and DRGs." The Nov. 15-16, 1984 symposium was sponsored by Bridgeport Hospital, Bridgeport, Conn., and supported by contributions from 20 companies (listed on page 29). Portions of this article are also based on a presentation by Drs. Freeman and Mullin at the Tri-Service Performance Measurement Conference, June 11-15, 1984, sponsored by the Army Medical Department.
Focused utilization review efforts to date have centered on patient categories, i.e., diagnosis, service, or classification. Since the patient's length of stay is mostly controlled by the attending practitioner, it seemed logical to use practitioner profiles to focus review. The profiles developed compare each practitioner's patients, case-mix-adjusted, using diagnosis-related groups, to statewide length-of-stay norms. Standards (range of acceptable variations from the norm) can be adjusted to increase or decrease the impact of the review. After experience, standards were set that resulted in a significant decrease in the average length of stay and a resultant significant drop in patient days.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.