Diagnosis Related Groups resemble the activities performed by a hospital for a group of diagnoses. This standardised way of registering activities opens the door for a forceful benchmark. In the Netherlands Tragpi has developed a benchmark based on these principles, which is in use in over 50 hospitals. Hospitals use this benchmark to analyse, identify and manage their efficiencies/inefficiencies per patient group.

Tragpi have expanded their Benchmark from the Dutch setting into an international setting. The Netherlands maintain a variant (DBC’s) of the internationally used Diagnosis Related Groups (DRG’s). From the second quarter of 2012 this Dutch variant is transformed into the internationally used DRG’s. This will create the possibility to benchmark Irish hospitals with its Dutch peers.

 

Using the DRG Benchmark
The DRG Benchmark Online enables us to compare the DRG production of a hospital with the reference. Hospitals can choose whether they would like to be compared to their peers in their own district, country or abroad. Next to this, it is possible to create a comparison by size.

The DRG Benchmark Online is a comparison per individual DRG. In this benchmark, per DRG the profile of activities with their costs, are compared with the profiles and costs of peer institutions. This enables hospitals to analyse differences with the benchmark; where do we score better than the benchmark, where is the benchmark more efficient? Do these differences originate from different protocols used by medical specialists or is it caused by higher cost prices per activity? In other words, does the hospital perform more activities per DRG or is the cost price per activity higher?

The online tool allows us, in several ways of analysis, to enable potential inefficiencies at a glance. Is there a specific specialism which performs less than the benchmark? Is this caused by specific types of activities? Is the inefficiency in these specific activities caused by a higher cost price or does the hospital perform these activities more than the benchmark?

The Benchmark is created for several users. For Hospital Management the tool allows, in several approaches, to analyse the hospitals’ performance; insight into efficiencies/inefficiencies which are shown on the level of departments, medical specialties, diagnoses groups and patient groups. Doctors can evaluate and improve their own performance by analysing their level of activities per diagnoses group. Heads of Departments use the benchmark to analyse and improve the cost prices of the activities performed in their department. The online Benchmark tool is user friendly in order to make sure the benchmark is functional for any of these users.

Process
The basis of the DRG Benchmark is the Tragpi Costing model in which cost prices per activity are calculated. These cost prices per activity are the input for the DRG Benchmark, which uses profiles of activities per DRG and their costs to estimate the actual costs per DRG. In order to create this valid DRG Benchmark, detailed hospital information is used. Data on a patient level is derived from the Hospitals Information System. To create profiles per DRG, the activities performed on patients as well as the DRG / ICD for a full year are derived. Next to this, an extraction of the costs of this year will be made.