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Question:

The report discusses the data and analysis of the same for UTS Hospital which is a public hospital located in Australia in New South Wales. An extensive analysis is done on the AR-DRGs E69A/B/C which is the code for Bronchitis and Asthma.
 
 

Answer:

Chronic Asthmatic Bronchitis - Health Library. (2016). Sw.org. Retrieved 23 May 2016.

AR-DRG

Australian Refined Diagnosis Related Groups (AR-DRGs) is a classification system that puts forward a clinical mechanism to relate the patients that are treated in a particular hospital with the resources that are utilized by the hospital. These groupings have been done on the basis of the similarities found in the clinical status and the required hospital service for the same. ("Australian refined diagnosis-related groups (AR-DRG) data cubes (AIHW)", 2016).

Code

Description

 

00

Unassignable to MDC                                                                    

 

01

Diseases & Disorders of the Nervous System                                            

B01Z-B81B

02

Diseases & Disorders of the Eye                                                       

C01Z-C63B

03

Diseases & Disorders of the Ear, Nose, Mouth & Throat                                 

D01Z-D67Z

04

Diseases & Disorders of the Respiratory System                                        

E01A-E75C

05

Diseases & Disorders of the Circulatory System                                        

F01Z-F75C

06

Diseases & Disorders of the Digestive System                                          

G01A-G70B

07

Diseases & Disorders of the Hepatobiliary System & Pancreas                           

H01A-H64B

08

Diseases & Disorders of the Musculoskeletal System & Connective Tissue                

I01Z-I76C

09

Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast                        

J01Z-J67B

10

Endocrine, Nutritional & Metabolic Diseases & Disorders                               

K01Z-K64B

11

Diseases & Disorders of the Kidney & Urinary Tract                                    

L01A-L67C

12

Diseases & Disorders of the Male Reproductive System                                  

M01Z-M64Z

13

Diseases & Disorders of the Female Reproductive System                                

N01Z-N62B

14

Pregnancy, Childbirth & the Puerperium                                                

O01A-O65B

15

Newborns & Other Neonates                                                             

P01Z-P67D

16

Diseases & Disorders of Blood, Blood Forming Organs, Immunological Disorders          

Q01Z-Q62B

17

Neoplastic Disorders (Haematological & Solid Neoplasms)                               

R01A-R64Z

18

Infectious & Parasitic Diseases, Systemic or Unspecified Sites                        

S60Z-T64B

19

Mental Diseases & Disorders                                                           

U40Z-U68Z

20

Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders                      

V60Z-V64Z

21

Injuries, Poisonings & Toxic Effects of Drugs                                         

W01Z-X64B

22

Burns                                                                                 

Y01Z-Y62B

23

Factors Influencing Health Status & Other Contacts with Health Services

Z01A-Z65Z

E69A/B/C

DGR E69A/B/C belongs to the MDC 04 which stands for Diseases & Disorders of the Respiratory System. This DRG belongs to the disease Bronchitis and Asthma. Bronchitis is a respiratory malady in which the bodily fluid layer in the lungs' bronchial sections gets to be kindled. As the bothered layer swells and develops thicker, it contracts or stops the minor aviation routes in the lungs, bringing about hacking spells that might be joined by mucus and shortness of breath. The malady comes in two structures: intense (enduring from one to three weeks) and endless (enduring no less than 3 months of the year for a long time in succession). Asthma is a constant sickness including the aviation routes in the lungs. These aviation routes, or bronchial tubes, permit air to come all through the lungs.                                

Prevalence & Incidence of Admissions to Acute Hospitals

Acute care is a branch of health care that is secondary in nature. Under this care, a patient receives active and immediate but short-term treatment. The treatment is provided for long illness, severe injury or an urgent medical condition. It is entirely opposite from the long-term or chronic care ("Acute hospitals and integrated care", 2015).

AMO specialty that is seen more commonly is general medicine and the discharge intention is overnight as compared to the same day discharge. J45.9 is the most frequent diagnosis code and 95550-03 is the major procedure code.

Prevent Hospitalization and Reduce LOS for E69A/B/C

There is no cure for asthma, yet side effects can be controlled with compelling asthma treatment and administration. This includes taking the medicines as guided and figuring out how to keep away from triggers that bring about asthma side effects.

Ordinary treatment for intense bronchitis may comprise of straightforward measures, for example, getting a lot of rest, drinking loads of liquids, staying away from smoke and exhaust, and potentially getting a medicine for a breathed in bronchodilator and/or hack syrup. Now and again of incessant bronchitis, oral steroids to decrease aggravation and/or supplemental oxygen might be important.

Over-the-counter non-steroidal mitigating drugs (NSAIDS, for example, headache medicine, ibuprofen and naproxen may relieve your sore throat. Humidifiers make dampness noticeable all around you relax. This can release bodily fluid in your nasal sections and mid-section, making it simpler to relax. Drinking a lot of fluids, for example, water or tea, can disperse bodily fluid. This makes it less demanding to hack it up or clean out it out through your nose.

Data Analysis – Strategy and Plan

The selected plan for analyzing the data for the patients of UTS Hospital diagnosed and treated with the DRG E69A/E69B/E69C is:

  • Sort the information for each of the DGR as E69A, E69B and E69C.
  • Compare the data collected with the overall data of the patients
  • Identify the commonly occurring diagnostic information and procedure information on the Bronchitis and Asthma patients
  • Analyze the data and infer the patterns out of the data such as the age group that is affected the most, gender than is affected the most and likewise
  • Look through the discharge information and the period of stay of the patients in the hospital
  • Combine all of the information in the form of tables, figures and charts

Profile of patients in AR-DRGs E69A/E69B/E69C

The data set that has been chosen for this study consists of 34624 records and the proportion covered by AR-DRG E69A/B/C is 413 records which accounts for 1.192% of the entire dataset with 0.037% patients treated for E69A, 0.26% treated for E69B and 0.895% for E69C.

DRG41

Gender

Age

Marital Status

LOS

Discharge Intention

ICU Hours

Principal Diagnosis

Diagnosis 2

E69A

Female

75

Married

20

Overnight

0

J45.9

B44.9

E69A

Female

83

Widowed

5

Overnight

0

J20.8

B96.5

E69A

Female

53

Married

22

Overnight

0

J46

G72.2

E69A

Female

64

Married

3

Overnight

0

J20.9

F10.2

E69A

Female

86

Widowed

6

Overnight

0

J45.1

F03

E69A

Male

77

Married

8

Overnight

0

J45.9

J69.0

E69A

Female

78

Widowed

1

Overnight

0

J45.9

I50.0

E69A

Male

75

Married

9

Overnight

0

J45.9

D50.9

E69A

Female

72

Unknown

16

Overnight

0

J45.9

E87.7

E69A

Male

85

Unknown

3

Overnight

0

J40

J18.9

E69A

Male

62

Married

1

Overnight

0

J45.9

I48

E69A

Female

66

Widowed

4

Overnight

0

J45.9

B96.39

E69A

Female

63

Married

1

Overnight

2

J20.8

B96.5

Profile of Patients

DRG41

Gender

Age

Marital Status

LOS

ICU Hours

Principal Diagnosis

Diagnosis 2

E69B

Male

37

Married

13

0

J46

B96.39

E69B

Female

30

Married

4

16

J46

A49.2

E69B

Female

58

Married

3

0

J45.9

Z72.0

E69B

Male

55

Single

5

0

J45.9

J06.9

E69B

Female

40

Married

26

0

J45.9

J14

E69B

Male

6

Single

1

0

J45.9

G80.9

E69B

Female

3

Single

1

0

J45.9

A09

E69B

Female

70

Divorced

6

0

J45.9

J22

E69B

Female

81

Widowed

7

0

J45.9

E11.9

E69B

Female

51

Married

1

0

J45.9

 

E69B

Male

76

Married

1

0

J45.1

 

E69B

Female

77

Married

6

0

J20.9

E11.9

E69B

Male

66

Unknown

2

27

J46

Z86.43

E69B

Female

45

Married

3

0

J45.9

D50.9

E69B

Female

0

Single

1

0

J45.9

J05.0

E69B

Male

16

Single

3

44

J45.9

J93.9

E69B

Male

66

Unknown

1

0

J45.9

 

E69B

Female

28

Single

1

0

J45.9

I47.1

E69B

Male

8

Single

11

0

J45.9

G80.9

E69B

Male

53

Single

6

0

J45.9

 

E69B

Female

57

Married

2

0

J45.9

Z86.43

E69B

Female

1

Single

2

0

J45.9

J18.9

E69B

Male

52

Married

3

0

J45.9

Z72.0

 Pivot Table: Profile of Patients for E69B

DRG41

Gender

Age

Marital Status

LOS

Discharge Intention

ICU Hours

Principal Diagnosis

Diagnosis 2

E69C

Female

7

Single

1

Overnight

0

J45.9

 

E69C

Male

1

Single

1

Overnight

0

J45.9

 

E69C

Female

17

Single

1

Overnight

0

J45.9

 

E69C

Male

5

Single

1

Overnight

0

J45.9

 

E69C

Male

32

Married

1

Overnight

0

J45.9

 

E69C

Male

12

Single

1

Overnight

0

J45.9

 

E69C

Male

32

Single

1

Overnight

0

J45.9

 

E69C

Female

15

Single

1

Overnight

0

J45.9

Z72.0

E69C

Male

2

Single

1

Overnight

0

J45.9

 

E69C

Male

41

Married

1

Overnight

0

J20.9

L50.0

E69C

Female

35

Single

1

Overnight

0

J45.9

Z72.0

E69C

Male

4

Single

1

Overnight

0

J45.9

 

E69C

Female

1

Single

1

Overnight

0

J45.9

 

E69C

Male

29

Married

1

Overnight

0

J45.9

Z72.0

E69C

Male

2

Single

2

Overnight

0

J45.9

 

E69C

Female

14

Single

2

Overnight

0

J45.9

J06.9

E69C

Male

47

Single

1

Overnight

0

J45.9

Z86.43

E69C

Male

31

Single

1

Overnight

22

J46

J06.9

E69C

Male

1

Single

2

Overnight

0

J45.9

 

E69C

Female

18

Single

1

Overnight

0

J45.9

 

E69C

Female

6

Single

1

Overnight

0

J45.9

E86

E69C

Female

20

Single

3

Overnight

0

J46

Z72.0

E69C

Female

33

Single

1

Overnight

0

J45.9

 

E69C

Male

47

Single

1

Overnight

0

J45.9

 

E69C

Female

49

Unknown

1

Overnight

0

J45.9

 

E69C

Male

1

Single

2

Overnight

0

J46

 

E69C

Male

2

Single

5

Overnight

0

J46

J06.9

E69C

Female

20

Single

1

Overnight

0

J45.9

 

E69C

Female

35

Single

3

Overnight

0

J45.9

J06.9

E69C

Male

4

Single

1

Overnight

0

J45.9

 

E69C

Female

1

Single

1

Overnight

0

J45.9

 

E69C

Female

35

Single

1

Overnight

0

J45.9

Z72.0

E69C

Male

21

Single

2

Overnight

0

J45.9

 

E69C

Female

17

Single

2

Overnight

0

J45.9

J06.9

E69C

Female

19

Single

1

Overnight

0

J45.9

 

E69C

Male

17

Unknown

1

Overnight

0

J40

Z72.0

E69C

Male

3

Single

2

Overnight

0

J45.9

 

E69C

Female

17

Single

3

Overnight

0

J45.9

 

E69C

Male

3

Single

1

Overnight

0

J45.9

J06.9

E69C

Male

7

Single

1

Overnight

0

J45.9

 

E69C

Male

30

Married

2

Overnight

20

J45.9

Z72.0

E69C

Female

35

Married

1

Overnight

0

J45.9

J06.9

E69C

Male

4

Single

1

Overnight

0

J45.9

J22

E69C

Female

1

Single

2

Overnight

0

J45.9

J06.9

E69C

Male

48

Married

2

Overnight

0

J45.9

Z86.43

E69C

Male

2

Single

1

Overnight

0

J45.9

 

E69C

Female

17

Single

2

Overnight

38

J46

 

E69C

Male

1

Single

1

Overnight

0

J45.9

 

E69C

Male

12

Single

2

Overnight

0

J45.9

 

E69C

Male

1

Single

1

Overnight

0

J45.9

L30.9

E69C

Female

15

Single

1

Overnight

0

J45.9

J06.9

E69C

Male

0

Single

1

Overnight

0

J45.9

L30.9

E69C

Male

38

Unknown

1

Overnight

0

J45.9

 

E69C

Male

1

Single

1

Overnight

0

J45.9

J22

E69C

Male

1

Single

1

Overnight

0

J45.9

 

E69C

Female

32

Married

2

Overnight

0

J45.1

 

E69C

Male

6

Single

2

Overnight

0

J45.9

 

E69C

Male

8

Single

1

Overnight

0

J45.9

J06.9

E69C

Male

15

Single

1

Overnight

0

J40

 

E69C

Male

25

Single

4

Overnight

0

J45.1

 

E69C

Male

20

Unknown

1

Overnight

0

J45.9

 

E69C

Male

2

Single

1

Overnight

0

J45.9

 

E69C

Male

7

Single

1

Overnight

0

J45.9

 

E69C

Male

2

Single

1

Overnight

0

J45.9

 

E69C

Male

1

Single

1

Overnight

0

J45.9

 

E69C

Female

1

Single

2

Overnight

0

J45.9

J06.9

E69C

Male

2

Single

1

Overnight

0

J45.9

 

E69C

Female

31

Married

1

Overnight

0

J45.9

 

E69C

Male

1

Single

1

Overnight

0

J45.9

 

E69C

Female

8

Single

1

Overnight

0

J45.9

J06.9

Comparison and Analysis

DRG

Number of Patients

Average Age

Number of Females

Number of Males

Overnight Discharge

Same Day Discharge

Maximum ICU Hours

E69A/B/C

410

22.6 years

190

223

409

4

46

Others

34214

39.27

20010

14201

27390

6525

2695

Comparison of Patients in AR-DRG with E69A/B/C with all the patients

The comparative analysis between the patients of E69A/B/C and other DRGs show the following trends and results:

  • More number of males have been diagnosed with E69A/B/C whereas more females are diagnosed for other DRGs
  • Overnight discharges occur more than the same day discharges for all the DRGs
  • Maximum ICU hours in case of Bronchitis and Asthma is 46 but it went as high as up to 2695 hours in other DRGs
  • The average age recorded for Asthma and Bronchitis is 22.6 years and is 39.27 for the rest of them. 

DRG

Most Common Principal Diagnosis

Most Common Secondary Diagnosis

E69A

J45.9

B96.5

E69B

J45.9

J18.9

E69C

J45.9

J06.9

Most Common Diagnosis Codes

DRG

Most Common Principal Procedure Code

Most Common Secondary Principal Procedure

E69A

95550-01 and 95550-03

95550-03

E69B

95550-03

95550-01, 95550-02 and 95550-03

E69C

95550-03

34524-00

Most Common Procedure Codes

DRG

Maximum Length of Stay

E69A

2

E69B

44

E69C

46

Same MCDs

743

Maximum Length of Stay

Important Points from the Analysis

  • Principal diagnosis most commonly seen: J45.9
  • Most common Procedure codes: 95550-03
  • Overnight discharges happen more than same day discharges
  • More males diagnosed with Bronchitis and Asthma

Prevention for Asthma and Bronchitis

  • Intake of proper medications as per the recommendations by the doctor or caregiver.
  • Avoid the harm causing factors such as pollen grains, smoke and likewise.
  • Increased use of electrostatic air cleaner to be free from dust
  • Increased consumption of water on a daily basis and especially in the mornings
  • Bring exercise and workout in the routine schedule
  • Get rid of the pets is animal dander is one of the causes of Asthma
  • Be well aware of the medical condition
  • Maintain wellness
  • Seek medical care if the problems increase ("Chronic Asthmatic Bronchitis - Health Library", 2016)

Conclusions

Bronchitis and Asthma are the diseases that are primarily treated in the Acute Care facility and can be chronic as well as non-chronic in nature. A detailed analysis on the profile of the patients is done in a record of 34624 patients. There are 413 patients belonging to E69A/B/C DRG and the principal diagnosis and procedure codes seen are J45.9 and 95550-03. 

 

References

Acute hospitals and integrated care. (2015). The King's Fund. Retrieved 23 May 2016.

An Inpatient Prospective Payment System Refresher: MS-DRGs. (2016). Health-information.advanceweb.com. Retrieved 23 May 2016.

Australian refined diagnosis-related groups (AR-DRG) data cubes (AIHW). (2016). Aihw.gov.au. 

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