Title: A decision aiding methodology to compare patient classification systems

Authors: María A. De Vicente y Oliva; Sarah Ben Amor; Jaime Manera Bassa; Isabel Caballero López Fando; Ángel Gómez Delgado; Pablo De Miguel Bohoyo

Addresses: Universidad Rey Juan Carlos, Paseo de los Artilleros s/n 28032, Madrid, Spain ' Telfer School of Management, 55 Laurier Avenue East, Ottawa, Ontario K1N 6N5, Canada ' Universidad Rey Juan Carlos, Paseo de los Artilleros s/n 28032, Madrid, Spain ' Hospital Universitario de Fuenlabrada, C/ Camino del Molino, 2, 28942 - Fuenlabrada, Spain ' Hospital Universitario del Sureste, Ronda del Sur, 10, 28500 - Arganda del Rey, Spain ' Hospital Universitario de Fuenlabrada, C/ Camino del Molino, 2, 28942 - Fuenlabrada, Spain

Abstract: Spanish public hospitals funding depends on the classification of attended pathologies. These pathologies are grouped thanks to a patient classification system (PCS) into the so-called diagnostic related groups (DRGs). International Classification of Diseases (ICD) coding systems generate various DRGs. Based on the ICD-9, the all patients diagnostic related groups (AP-DRGs) were used. In January 2016, Spain adopted ICD-10. One of the casualties from this transition was the AP-DRG PCS which did not accept information coded with ICD-10. A new system had to be adopted. In this paper we develop a methodology to assist decision-makers who are charged with evaluating and determining replacement PCS in the context of scarce resources and limited hospital funding. We ground our approach in a rigorous analytical framework is order to understand the pros and cons of candidate systems, from both clinical and managerial perspectives. We propose a multicriteria decision-aiding approach based on the outranking method, ELECTRE III to produce a ranking of the different options. The methodology is applied to a case study of a Spanish hospital where the change from ICD-9 to ICD-10 has already occurred.

Keywords: hospital management; patients classification system; PCS; multicriteria evaluation; ICD-9; ICD-10; AP-DRG; APR-DRG; IR-DRG; 3M; ELECTRE III.

DOI: 10.1504/IJMCDM.2018.094383

International Journal of Multicriteria Decision Making, 2018 Vol.7 No.3/4, pp.177 - 194

Received: 27 Oct 2016
Accepted: 10 Sep 2017
Published online: 31 Aug 2018 *

Full-text access for editors Full-text access for subscribers Purchase this article Comment on this article