Changepoint analysis of gestational age and birth weight: proposing a refinement of Diagnosis Related Groups.

Endrich, Olga; Triep, Karen; Torbica, Nenad; Nakas, Christos T.; Nelle, Mathias; Fiedler, Georg; Raio, Luigi (2020). Changepoint analysis of gestational age and birth weight: proposing a refinement of Diagnosis Related Groups. Pediatric research, 87(5), pp. 910-916. Springer Nature 10.1038/s41390-019-0669-0

Text s41390-019-0669-0.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (2MB)

BACKGROUND

Although the complexity and length of treatment is connected to the newborn's maturity and birth weight, most case-mix grouping schemes classify newborns by birth weight alone. The objective of this study was to determine whether the definition of thresholds based on a changepoint analysis of variability of birth weight and gestational age contributes to a more homogenous classification.

METHODS

This retrospective observational study was conducted at a Tertiary Care Center with Level III Neonatal Intensive Care and included neonate cases from 2016 through 2018. The institutional database of routinely collected health data was used. The design of this cohort study was explorative. The cases were categorized according to WHO gestational age classes and SwissDRG birth weight classes. A changepoint analysis was conducted. Cut-off values were determined.

RESULTS

When grouping the cases according to the calculated changepoints, the variability within the groups with regard to case related costs could be reduced. A refined grouping was achieved especially with cases of >2500 g birth weight. An adjusted Grouping Grid for practical purposes was developed.

CONCLUSIONS

A novel method of classification of newborn cases by changepoint analysis was developed, providing the possibility to assign costs or outcome indicators to grouping mechanisms by gestational age and birth weight combined.

Interest & Impact

Downloads

2 since deposited on 16 Dec 2019
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item