UTS Hospital Data Analysis: AR-DRG E69A/B/C essay.

Australian Refined Diagnosis Related Groups (AR-DRGs)

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.

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

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

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.

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.

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.

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

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

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

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

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

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

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

DRG	Maximum Length of Stay
E69A	2
E69B	44
E69C	46
Same MCDs	743

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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