A decision aiding methodology to compare patient classification systems

María A. De Vicente y Oliva, Sarah Ben Amor, Jaime Manera Bassa, Isabel Caballero López Fando, Ángel Gómez Delgado and Pablo De Miguel Bohoyo

International Journal of Multicriteria Decision Making, 2018, vol. 7, issue 3/4, 177-194

Abstract: Spanish public hospitals funding depends on the classification of attended pathologies. These pathologies are grouped thanks to a patient classification system (PCS) into the so-called diagnostic related groups (DRGs). International Classification of Diseases (ICD) coding systems generate various DRGs. Based on the ICD-9, the all patients diagnostic related groups (AP-DRGs) were used. In January 2016, Spain adopted ICD-10. One of the casualties from this transition was the AP-DRG PCS which did not accept information coded with ICD-10. A new system had to be adopted. In this paper we develop a methodology to assist decision-makers who are charged with evaluating and determining replacement PCS in the context of scarce resources and limited hospital funding. We ground our approach in a rigorous analytical framework is order to understand the pros and cons of candidate systems, from both clinical and managerial perspectives. We propose a multicriteria decision-aiding approach based on the outranking method, ELECTRE III to produce a ranking of the different options. The methodology is applied to a case study of a Spanish hospital where the change from ICD-9 to ICD-10 has already occurred.

Keywords: hospital management; patients classification system; PCS; multicriteria evaluation; ICD-9; ICD-10; AP-DRG; APR-DRG; IR-DRG; 3M; ELECTRE III. (search for similar items in EconPapers)
Date: 2018
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