introduction to hrg4 reference cost grouper presented by chris knee senior information analyst and...
TRANSCRIPT
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Introduction to HRG4 Reference Cost Grouper
Presented byChris Knee Senior Information Analyst and
Peter Broughton Senior Casemix Consultant
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Contents of this Session
Presentation on using the HRG4 Reference Cost Grouper
Demonstration of the key features of the HRG4 Reference Cost Grouper
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Using the HRG4 Reference Cost Grouper
Chris Knee
Senior Information Analyst
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Presentation Overview
What’s New
Data Preparation Required
Input Data
Output Data
Summary
Grouper Demonstration
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What’s New – Part 1
3 in 1 - Report Generator and Spell Converter now integrated with the Grouper
The Grouper processes Spells and Episodes
User selects Trim Point Data
Unbundling – potential for output to contain more than one HRG per Episode and Spell
New code structure e.g. AA01Z not A01
Additional datasets can be processed e.g. Out-patient Attendance
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What’s New – Part 2
Enhanced Data Validation
Mandatory fields validated before grouping (document – www.ic.nhs.uk/casemix/prepare)
Internal consistency checked during grouping
Any identified errors are grouped to HRG “UZ01Z Data Invalid for Grouping”
An error report is produced on run completion
For APC, if one of the Episode HRGs in a Spell is UZ01Z, then the Spell HRG is UZ01Z
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Data Preparation – Part 1
Admitted Patient Care
Sorting The Input File must be sorted by Hospital Provider Spell
Number and then by Episode Number
Derived Items Age at Episode Start is required Episode Duration
Critical Care days need to be removed from Episode Duration (as in previous years)
Episode Duration should not be negative
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Data Preparation – Part 2
Non-Admitted Patients
Sorting No sorting required
Derived Items Age at Attendance Date is required
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Input Data Files – Part 1
Six datasets can be processed by the Grouper
Admitted Patient Care
Out-patient Attendance
Accident & Emergency
Adult Critical Care
Paediatric Critical Care
Neonatal Critical Care
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Input Data Files - Part 2
As with previous Grouper
Two file formats can be processed CSV (Comma separated values) Fixed Width
For APC, input files must be at Episode level not Spell level
There are a number of mandatory fields specified in the Record Definition File
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Record Definition File
As with the previous Grouper
The RDF tells the HRG Grouper where the mandatory fields are located within the Input File
The Grouper requires one RDF to be defined for each input dataset
The Grouper is supplied with sample RDFs
Users can define their own RDFs
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Output Files
There are three Output Files
1. Main Output File
2. Error Report
3. Report File (replaces Report Generator)
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Main Output FileIncluded within the Main File are
Original input data
Grouper derived fields
Spell HRG (repeated for each Episode) Spell Dominant Procedure Spell Primary Diagnosis Episode HRG Episode Dominant Procedure 0 or more Unbundled HRGs Episode Trim Point Episode Excess Bed Days Programme Budget Code
Note: Episodes assigned to UZ01Z are also included
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Error Report File
Provides additional information for records in the Main Output File grouped to “UZ01Z Data Invalid for Grouping”
Report shows ALL errors for each record grouped to UZ01Z
Each record in the Error Report File will have a code and description of the error
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Example Error Types
Invalid Primary Diagnosis Diagnosis does not exist / Not valid in primary position
Poorly Coded Primary Diagnosis Diagnosis exists and is valid but too unspecific to determine resource use
and group
Age Conflicting with Diagnosis E.g. Complications of pregnancy in a 5-year old child
Invalid Primary Procedure Procedure does not exist / Not valid in primary position
Poorly Coded Primary Procedure Procedure exists and is valid but too unspecific to determine resource use
and group
Age Outside Range 0 - 130 Years
www.ic.nhs.uk/casemix/prepare
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Summary
What’s New
Input Data (including data preparation)
Output Data
Questions?
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HRG4 Reference Cost Grouper Demonstration
Peter Broughton
Senior Casemix Consultant
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Contents of Presentation
Pre-release software issues
Creating a Record Definition File
Single spell grouping
A selection of file grouping scenarios
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Multiple Trauma – Review Trauma means non-superficial injury (e.g. broken
limb bone) Requirements
In the first episode of the spell: Primary diagnosis of trauma Another diagnosis of trauma from a different
trauma site (body is divided into nine areas)
Diag1 (trauma) Diag2 (non-trauma) Diag3 (trauma)
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Non-Admitted Care HRG allocation is based on OPCS code E.g. Procedure H28.9 (Rigid Sigmoidoscopy) produces HRG
FB03A Endoscopic or intermediate large intestinal procedures 19 years and over
If no OPCS code, then HRG is WF01Z Non-Admitted Attendance
Multi-professional clinics identified by OPCS code X62.2 and X62.3 (HRG is WF02Z)
Diagnosis is ignored Where APC HRG is based on procedure, then the Non-
Admitted HRG will be the same for the same procedure(s) i.e. setting-independent
Where the APC HRG is influenced by diagnosis, the non-admitted HRG will be different
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Emergency and Urgent Care
Uses A&E data HRGs are based on Investigation and Treatment
codes There are 11 HRGs
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HRG4 Reference Cost Grouper Timetable 2007
1 April: HRG4 Grouper NHS UAT ends 20 April: HRG4 Grouper for Ref Costs released
1 March: HRG4 Grouper NHS UAT starts 19 March: HRG4 Grouper documentation:
overview, benefits, definitions, coding guidance
1 May: Dedicated Casemix helpdesk & triage commences
8 May: HRG4 trimpoints issued to NHS [FCE & Spells]
16 May: SHA/Nominated RC lead grouper training
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Summary
Covered in this presentation: Creation of a user-defined Record Definition
File Grouping a single spell Processing of different data sets, requiring the
use of different Record Definition Files A variety of HRG types (APC, Non-Admitted,
Unbundling, CC, Splits, Multiple Trauma)
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Questions