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The Trauma Registry Compared to All Patient Refined Diagnosis Related Groups (APR-DRG)
Jodi Hackworth, MPH, Johanna Askegard-Giesman, MD, Thomas Rouse, MD and Brian Bennyworth, MD, MS, Riley Hospital for Children at IU Health, Indianapolis IN

Abstract:
Background: Literature has shown there are significant differences between administrative databases and clinical registry data. Our objective is to compare the identification of trauma patients using All Patient Refined Diagnosis Related Groups (APR-DRG) as compared to the Trauma Registry and estimate the effects of those discrepancies on utilization. Methods: Admitted pediatric patients from 1/2012-12/2013 were abstracted from the trauma registry. The patients were linked to corresponding administrative data using the Pediatric Health Information System database. APR-DRGs referencing trauma were used to identify trauma patients. We compared variables related to utilization and diagnosis to determine the level of agreement between the two datasets. Results: There were 1942 trauma registry patients and 980 administrative records identified with trauma-specific APR-DRG during the study period. Forty-two percent (816/1942) of registry records had an associated trauma-specific APR-DRG; 69% of registry patients requiring ICU care had trauma APR-DRGs; 73% of registry patients with head injuries had trauma APR-DRGs. Only 21% of registry patients requiring surgical management had associated trauma APR-DRGs, and 12.5% of simple fractures had associated trauma APR-DRGs. Conclusion: APR-DRGs appear to only capture a fraction of the entire trauma population and it tends to be the more severely ill patients. As a result, the administrative data is not able to accurately answer hospital or operating room utilization as well as specific information on diagnosis categories regarding trauma patients. APR-DRG administrative data should not be used as the only data source for evaluating the needs of a trauma program.
Objective:
At the end of this activity, the learner will be able to describe the differences and similarities between administrative billing data and trauma registry data.
Objective Content: Effects of discrepancies and similarities between the two datasets will be estimated from patient utilization, outcomes and different types of injuries.


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