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

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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.


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.


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.


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.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Nakas, Christos T.; Fiedler, Georg Martin and Raio, Luigi


600 Technology > 610 Medicine & health




Springer Nature




Alexandra Müller

Date Deposited:

16 Dec 2019 12:43

Last Modified:

10 Apr 2020 01:31

Publisher DOI:


PubMed ID:





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