Statistics Area Clinical Financial Managment

As THCG experts we are committed with excellence and international leadership, counting with a outstanding curricular career, with a highly qualified technological knowledge backup and extend professional experience at HIS obtained within the best NHS worldwide and moved by a transforming and updating calling, supervise, evaluate, redirect or, if needed, redesign the statistical systems and clinical financial management from the contracting hospitals.

At THCG we contribute in a significative manner and completely determine to design and establish:

  1. The Statistical and Clinical Financial management Control unit, define their structure, elaborate the internal function rule and establish the operational circuits to reach the desire objectives in the time frame needed. Including the electric circuits set ups and the information systems needed to clinical data, related to health, collecting and recording, generated by the health activity offer in the hospitalization units, emergency, external consults and OR, whether this activities are emergency or schedule. The data collection will be made through information clinical systems that will be simple, useful, safe, effective, efficient , agile, flexible and reliable able to reflect the health activities reality that are being develop at the hospital at any given time. From this system we can highlight:

  • Information Systems to OR data collecting (medical control to quality and assistencial security be guaranteed, and Operating Room sheet: OR equipment records, anesthesia, OR occupation, in and outs schedule, suspension of schedules activities, …). Information system to collect hospitalization data, especially the data related to CBGD and patients moving records, including if they are being moved to other facilities.
  • Information system to collect data of external consults especially the immediate records of the service provided without any delay.
  • This also include systems to citation scheduled or emergency, and also the mandatory recording of patients upon arrival to the center.
  • Information System for data collecting at the ER (emergency room)
  1. The codification subunit, elaborate rules and integrate it by train administrative staff leader by a specialized medics and where the main goal it´s to elaborate and support the hospital CBGD.

  2. Elaborate and structure statistics indicators for hospital management and control centers to improve the management decision taking, base on data scientific evidence and real hospital activity.

  • Present hospital activity indicators and statistics (hospital now)
  • Present hospital activity indicators and statistics (activity history)
  1. To elaborate and structure the quality analysis indicators mainly from hospital activity; hospitalization and OR activity based on CBGD.

  2. To elaborate and structure the APR-GRDs (All Patient Refined DRGs) for the clinical financial management.

  3. Regularly realize expenses analysis and transformation of the hospital clinical activities rewarding financial data and financial management.

Ultimately, THCG contributes in a significant manner and completely determinant to circuit definition, design and generalize the implementation of palliations and technologies and SHI in order to reach an outstanding clinical financial management at the contracting hospitals.

THCG helps to:

  1. Make sure to obtain a patient identification without mistakes and a safe bonding and reliable at the HCE including:

  • The use of the Health Card for a reliable identification of the personal data, health coverage data, filiations, address, reference contact data and other health associates data.
  • Reliable identification of the health institution data, of HCE and their bonding with the patient, including reports and the rest of the clinical documentation.
  1. Ensure the electronic record of clinical data including multi-option records and other electronic systems that allow an easy collect and coding of records such us the use of predetermine templates, auto-text selection, etc. The SHI for clinical data records has been design with a global vision considering:

  • The coding needs of the informed hospital activity in the discharge reports and the elaboration of the records of hospital discharge. (CBGB)
  • The existing gap between the technology use by the medics and the terminology use for coding (CIE9, CIE10,… )
  • The records needs of not only medical diagnosis but also of all procedures, whether they are medical, surgery, diagnosis o therapeutic.
  • The needed requirements to classify hospitalization episodes in Diagnostic Related groups (DRG)
  1. Coding according to the actual legal rules, the clinical records of hospital activities through the International Illness Classification (CIE.9.MC / CIE.10.MC…etc.). The coding clinical data include medical diagnosis and diagnosis procedures and therapeutically used, having into consideration all other use resources, the complexity of the assistencial process and medical terminology used on the report making.

  2. To elaborate according with the actual legal rules (CBGB), the record of informed and coded hospitals discharge (diagnosis and procedures). The data and records of the CBGD form the reference results for the comparative analysis of the casuistry and hospital functionality along with others NHS hospitals. They are a data and indicator group that define the hospital function in relation with the hospitalization periods they may had.

  3. To elaborate the analysis indicators of hospital activity according to CBGD.

  4. Classified, the informed hospital periods when discharge, code by the CIE and register, according to the actual legal rules (CBGD) by the Diagnosis Related Groups (DRG) at the “All patient” mode on state to the analysis year (25 version of the AP-GRD on state). Using the avaible aggregators to classify each hospitalization period on their corresponding DRG vs AP- DRG. The information to include to each DRG it´s the following:

  • Code, literal and type
  • Total number of valid discharge and half stay
  • Nº of refined discharge without extreme values of staying and refined half stay of discharge without extreme values.
  • Nº of extreme cases, that stays over superior cutting point staying.
  • Nº of extreme cases, that stays less than the cutting point staying.
  • Mortality or total of exit discharges
  • Inferior cutting point: DRG staying below to which it´s consider an extreme case, obtain through the formula: Percentile 25 – 1,5 * (Percentile 75 – Percentile 25)
  • Superior cutting point: DRG staying above of which it´s consider an extreme case, obtain through the formula: Percentile 75 + 1,5 * (Percentile 75 – Percentile 25)
  1. To control the expenses of the hospital activity through the clinical financial management, once the hospitalization periods had been classified according to the corresponding DRG vs AP-DRG. The cost of the DRG it´s determine at a central level and the expenses of each DRG are fixed through relative weighs convertible to money units. They use informatical programs (GESCTO…) to segregate the reference hospital clinical services expenses.