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

Abstract

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.

Authors+Show Affiliations

Inselspital, University Hospital of Bern, Berne, Switzerland. Insel Data Science Center IDSC, Inselspital, University Hospital of Bern, Berne, Switzerland.Inselspital, University Hospital of Bern, Berne, Switzerland. karen.triep@insel.ch.Inselspital, University Hospital of Bern, Berne, Switzerland.University Institute of Clinical Chemistry, Inselspital, University Hospital of Bern, Berne, Switzerland. Laboratory of Biometry, School of Agriculture, University of Thessaly, Nea Ionia, Magnesia, Greece.Neonatology Division, University Hospital of Zurich, Zurich, Switzerland.Inselspital, University Hospital of Bern, Berne, Switzerland. University Institute of Clinical Chemistry, Inselspital, University Hospital of Bern, Berne, Switzerland.Department of Obstetrics & Gynecology, University Hospital of Bern, Berne, Switzerland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31715621

Citation

Endrich, Olga, et al. "Changepoint Analysis of Gestational Age and Birth Weight: Proposing a Refinement of Diagnosis Related Groups." Pediatric Research, 2019.
Endrich O, Triep K, Torbica N, et al. Changepoint analysis of gestational age and birth weight: proposing a refinement of Diagnosis Related Groups. Pediatr Res. 2019.
Endrich, O., Triep, K., Torbica, N., Nakas, C. T., Nelle, M., Fiedler, M., & Raio, L. (2019). Changepoint analysis of gestational age and birth weight: proposing a refinement of Diagnosis Related Groups. Pediatric Research, doi:10.1038/s41390-019-0669-0.
Endrich O, et al. Changepoint Analysis of Gestational Age and Birth Weight: Proposing a Refinement of Diagnosis Related Groups. Pediatr Res. 2019 Nov 12; PubMed PMID: 31715621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changepoint analysis of gestational age and birth weight: proposing a refinement of Diagnosis Related Groups. AU - Endrich,Olga, AU - Triep,Karen, AU - Torbica,Nenad, AU - Nakas,Christos T, AU - Nelle,Mathias, AU - Fiedler,Martin, AU - Raio,Luigi, Y1 - 2019/11/12/ PY - 2019/07/10/received PY - 2019/10/31/accepted PY - 2019/10/28/revised PY - 2019/11/13/entrez PY - 2019/11/13/pubmed PY - 2019/11/13/medline JF - Pediatric research JO - Pediatr. Res. N2 - 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. SN - 1530-0447 UR - https://www.unboundmedicine.com/medline/citation/31715621/Changepoint_analysis_of_gestational_age_and_birth_weight:_proposing_a_refinement_of_Diagnosis_Related_Groups L2 - http://dx.doi.org/10.1038/s41390-019-0669-0 DB - PRIME DP - Unbound Medicine ER -