A way of grouping the hospital treatment of patients by casemix to allow analysis of the appropriateness, efficiency and effectiveness of care. Each group contains cases that are clinically similar and will consume similar quantities of healthcare resources. There are, for example, a number of codes which would naturally map to the HRG 'COPD' e.g.emphysema; chronic obstructive pulmonary disease, unspecified; chronic obstructive pulmonary disease with acute exacerbation etc..These should all represent a similar demand on resources. Currently, the cost of such an admission is derived from an average length of stay in hospital and to define the care in somewhat greater detail, the HRGs are split on the basis of complications and comorbidity. One can almost add on an extra day for every comorbid factor e.g. diabetes, A/F. The national tariff (see below) is calculated at HRG level, but activity is usually reported at specialty level. Steve Connellan of the BTS is leading work to refine the Respiratory HRGs further (v4). For example he hopes there will be the option to code for ambulatory care and for short COPD admissions (eg Hospital at Home), acute exacerbations without or with ventilatory support and whether it is via NIV or intubation. HRGs do not include primary care coding or resource use. See Appendix 2. For the full respiratory list see letter D in the HRG definitions manual: click here. On behalf of the BTS, Steve Connellan has produced (September 2008) an extremely useful guide to coding respiratory care (see here) that can act as a discussion with governance leads about diagnosis and coding ambiguities, the importance of recording complications and comorbidities, greater use of the new OPCS codes including physiology measurement, AHP activity and interventions such a NIV support and oxygen assessment, creation of formal links with commissioners to consult on care packages, activity outside PbR and innovative approaches to integrated care.
A way of grouping the hospital treatment of patients by casemix to allow analysis of the appropriateness, efficiency and effectiveness of care. Each group contains cases that are clinically similar and will consume similar quantities of healthcare resources. There are, for example, a number of codes which would naturally map to the HRG 'COPD' e.g.emphysema; chronic obstructive pulmonary disease, unspecified; chronic obstructive pulmonary disease with acute exacerbation etc..These should all represent a similar demand on resources. Currently, the cost of such an admission is derived from an average length of stay in hospital and to define the care in somewhat greater detail, the HRGs are split on the basis of complications and comorbidity. One can almost add on an extra day for every comorbid factor e.g. diabetes, A/F. The national tariff (see below) is calculated at HRG level, but activity is usually reported at specialty level. Steve Connellan of the BTS is leading work to refine the Respiratory HRGs further (v4). For example he hopes there will be the option to code for ambulatory care and for short COPD admissions (eg Hospital at Home), acute exacerbations without or with ventilatory support and whether it is via NIV or intubation. HRGs do not include primary care coding or resource use. See Appendix 2. For the full respiratory list see letter D in the HRG definitions manual: click here.
On behalf of the BTS, Steve Connellan has produced (September 2008) an extremely useful guide to coding respiratory care (see here) that can act as a discussion with governance leads about diagnosis and coding ambiguities, the importance of recording complications and comorbidities, greater use of the new OPCS codes including physiology measurement, AHP activity and interventions such a NIV support and oxygen assessment, creation of formal links with commissioners to consult on care packages, activity outside PbR and innovative approaches to integrated care.
– see Next Stage Review
This is a national data warehouse for England of care provided by NHS hospitals and NHS hospital patients treated elsewhere. Click here for further information.
shortage of oxygen/low oxygen level in the blood. Identified using a pulse oximeter, a peg-like probe usually placed on the finger, that measures oxygen saturation in the blood. May or may not be associated with breathlessness.
The last printed version (please note the online version is more up to date) of the IMPRESS NHS Jargon Buster (pdf) is available to download here
Appendix 1
Appendix 2