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Diagnosis-related Group
Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups, with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter, PhD, of the Yale School of Management, and John D. Thompson, MPH, of the Yale School of Public Health.Fetter RB, Shin Y, Freeman JL, Averill RF, Thompson JD (1980) Case mix definition by diagnosis related groups. Medical Care 18(2):1–53 The system is also referred to as "the DRGs", and its intent was to identify the "products" that a hospital provides. One example of a "product" is an appendectomy. The system was developed in anticipation of convincing Congress to use it for reimbursement, to replace "cost based" reimbursement that had been used up to that point. DRGs are assigned by a "grouper" program based on ICD (International Classification of Diseases) diagnoses, procedures, age, sex, discharg ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hospital
A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital typically is the major health care facility in its region, with many beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers, rehabilitation hospitals, children's hospitals, seniors' (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric treatment (see psychiatric hospital) and certain disease categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on the sources of income received. A teac ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hip Replacement
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. A total hip replacement (total hip arthroplasty or THA) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is one of the most common orthopaedic operations, though patient satisfaction varies widely. Approximately 58% of total hip replacements are estimated to last 25 years. The average cost of a total hip replacement in 2012 was $40,364 in the United States, and about $7,700 to $12,000 in most European countries. Medical uses Total hip replacement is most commonly used to treat joint failure caused by osteoarthritis. Other indications include rheumato ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medical Classification
A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, which are used to track diseases and other health conditions, inclusive of chronic diseases such as diabetes mellitus and heart disease, and infectious diseases such as norovirus, the flu, and athlete's foot. Procedure classifications list procedure code, which are used to capture interventional data. These diagnosis and procedure codes are used by health care providers, government health programs, private health insurance companies, workers' compensation carriers, software developers, and others for a variety of applications in medicine, public health and medical informatics, including: * statistical analysis of diseases and therapeutic actions * reimbursement (e.g., to process claims in medical billing based on diagnosis-related groups) * knowledge-based and decisi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Diagnosis Code
In health care, diagnosis codes are used as a tool to group and identify diseases, disorders, symptoms, poisonings, adverse effects of drugs and chemicals, injuries and other reasons for patient encounters. Diagnostic coding is the translation of written descriptions of diseases, illnesses and injuries into codes from a particular classification. In medical classification, diagnosis codes are used as part of the clinical coding process alongside intervention codes. Both diagnosis and intervention codes are assigned by a health professional trained in medical classification such as a clinical coder or Health Information Manager. Several diagnosis classification systems have been implemented to various degrees of success across the world. The various classifications have a focus towards a particular patient encounter type such as emergency, inpatient, outpatient, mental health as well as surgical care. The International Statistical Classification of Diseases and Related Health Probl ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Case Mix Index
Case mix index (CMI) within health care and medicine, is a relative value assigned to a diagnosis-related group of patients in a medical care environment. The CMI value is used in determining the allocation of resources to care for and/or treat the patients in the group. Resource Use Groups Patients are classified into groups having the same condition (based on main and secondary diagnosis, procedures, age), complexity (comorbidity) and needs. These groups are known as Diagnosis Related Groups (DRG), or Resource Use Groups (RUG). Each DRG has a relative average value assigned to it that indicates the amount of resources required to treat patients in the group, as compared to all the other diagnosis-related groups within the system. The relative average value assigned to each group is its CMI. Hospital CMI The CMI of a hospital reflects the diversity, clinical complexity and the needs for resources in the population of all the patients in the hospital. The CMI value of a hospit ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Influenza A Virus Subtype H1N1
In virology, influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus. Major outbreaks of H1N1 strains in humans include the Spanish flu, the 1977 Russian flu pandemic and the 2009 swine flu pandemic. It is an orthomyxovirus that contains the glycoproteins hemagglutinin and neuraminidase. For this reason, they are described as H1N1, H1N2 etc., depending on the type of H or N antigens they express with metabolic synergy. Hemagglutinin causes red blood cells to clump together and binds the virus to the infected cell. Neuraminidase is a type of glycoside hydrolase enzyme which helps to move the virus particles through the infected cell and assist in budding from the host cells. Some strains of H1N1 are endemic in humans and cause a small fraction of all influenza-like illness and a small fraction of all seasonal influenza, for instance in 2004–2005. Other strains of H1N1 are endemic in pigs ( swine influenza) and in birds (avian influenza). Its size is in ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hospital Acquired Condition
A hospital-acquired condition (HAC) is an undesirable situation or condition that affects a patient and that arose during a stay in a hospital or medical facility. It is a designation used by Medicare/Medicaid in the US for determining MS-DRG reimbursement beginning with version 26 (October 1, 2008). Not only hospital-acquired infections but also any other situation or condition, such as pressure ulcers, blood type mismatch, or iatrogenic injury, can be a HAC. A patient at a hospital can be infected or otherwise degraded by hospital conditions and/or personnel in ways that are sometimes diagnosed as a "complication." The US Medicare system designates some 1000+ ICD-9-CM diagnoses, out of over 14000 (as of 2009), as possible HACs. On February 8, 2006, the President signed the Deficit Reduction Act (DRA) of 2005. Section 5001(c) of DRA requires the Secretary to identify conditions that are: (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that h ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
New York State Department Of Health
The New York State Department of Health (NYSDOH) is the department of the New York state government responsible for public health. It is headed by Health Commissioner Mary T. Bassett, who was appointed by Governor Hochul and confirmed by the Senate on December 1, 2021.New York State Department of Health"Commissioner biography"/ref> Its regulations are compiled in title 10 of the ''New York Codes, Rules and Regulations''. Public health infrastructure The CDC describes the public health infrastructure as three components: ''workforce capacity and competency'': the recruitment, continuing education, and retention of health professionals; ''organizational capacity'': the consortium of public health agencies and laboratories, working with private and nonprofit organizations; and ''information and data systems'': the up-to-date guidelines, recommendations and health alerts, and the information and systems that monitor disease and enable efficient communication. New York relies ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Tax Equity And Fiscal Responsibility Act Of 1982
The Tax Equity and Fiscal Responsibility Act of 1982 (), also known as TEFRA, is a United States federal law that rescinded some of the effects of the Kemp-Roth Act passed the year before. Between summer 1981 and summer 1982, tax revenue fell by about 6% in real terms, caused by the dual effects of the economy dipping back into recession (the second dip of the "double dip recession") and Kemp-Roth's reduction in tax rates, and the deficit was likewise rising rapidly because of the fall in revenue, and the rise in government expenditures. The rapid rise in the budget deficit created concern among many in Congress. TEFRA was created in order to reduce the budget gap by generating revenue through closure of tax loopholes, introduction of tougher enforcement of tax rules, rescinding some of Kemp-Roth's reductions in marginal personal income tax rates that had not yet gone into effect, and raising some rates, especially corporate rates. TEFRA was introduced November 13, 1981 and was ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Prospective Payment System
A prospective payment system (PPS) is a term used to refer to several payment methodologies for which means of determining insurance reimbursement is based on a predetermined payment regardless of the intensity of the actual service provided. It includes a system for paying hospitals based on predetermined prices, from Medicare. Payments are typically based on codes provided on the insurance claim such as these: * Diagnosis-related groups for hospital inpatient claims * Ambulatory Payment Classification for hospital outpatient claims * Current Procedural Terminology for other outpatient claims The PPS was established by the Centers for Medicare and Medicaid Services (CMS), as a result of the Social Security Amendments Act of 1983, specifically to address expensive hospital care. Regardless of services provided, payment was of an established fee. The idea was to encourage hospitals to lower their prices for expensive hospital care. In 2000, CMS changed the reimbursement system f ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
New Jersey
New Jersey is a state in the Mid-Atlantic and Northeastern regions of the United States. It is bordered on the north and east by the state of New York; on the east, southeast, and south by the Atlantic Ocean; on the west by the Delaware River and Pennsylvania; and on the southwest by Delaware Bay and the state of Delaware. At , New Jersey is the fifth-smallest state in land area; but with close to 9.3 million residents, it ranks 11th in population and first in population density. The state capital is Trenton, and the most populous city is Newark. With the exception of Warren County, all of the state's 21 counties lie within the combined statistical areas of New York City or Philadelphia. New Jersey was first inhabited by Native Americans for at least 2,800 years, with the Lenape being the dominant group when Europeans arrived in the early 17th century. Dutch and Swedish colonists founded the first European settlements in the state. The British later seiz ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Centers For Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes mai ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
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