Diagnosis-Related Group Weight and Derived Case Mix Index to Assess the Complexity among Twins
Rikizam M. Joya, Lesley Cottrell, Autumn Kiefer, Mark J. Polak
Abstract
OBJECTIVE: Diagnosis-related groups (DRGs) are used to summarize hospital morbidity and mortality. Each DRG has a weight which is important in calculating the case mix index (CMI), a numeric summary of disease complexity in a population of patients. We utilized DRG weight and resultant CMI to compare postnatal outcomes among singletons versus monochorionic and monoamniotic, monochorionic diamniotic, and dichorionic diamniotic twins. STUDY DESIGN: This single-center and retrospective cohort study evaluated DRGs assigned by the investigators, birth weight, gestational age, length of stay (LOS), NICU admission rate, and mortality in twin births between 2014 and 2016. Twins were analyzed depending on chorionicity and amnionicity. Overall, 3 months of singleton births served as the control. The CMI derived from DRG weights were compared across groups. RESULTS: < 0.001). CONCLUSION: DRG weight and CMI values summarize in-hospital complexity and can be a useful tool to evaluate differences in care complexity among groups of patients. KEY POINTS: · Using diagnosis-related group and case mix index to assess morbidities.. · Morbidities of twins are monochorionic-monoamniotic versus monochorionic-diamniotic versus dichorionic-diamniotic twins.. · Only seven diagnosis-related group in neonatology make it a valuable tool for clinicians..