Table 1 Inclusion criteria for SCAD 2008

Are in the top 100 for reimbursement amount, after sorting for Adjusted Relative Weight (RW)

Have large amount of 'abnormal' values defined as:

- Procedure does not match hospital capacity

- Diagnosis and procedure codes are not correct

- Admission of ambulatory cases

- Larger among of reimbursement than other hospitals with similar size

- 'High-cost DRG (RW > 4)

Medical record that has:

- RW >= 8 but Length of Stay (LOS) < 3

- RW < 5 but LOS > 10 or > 2 times the average LOS of the same DRG

- Tracheostomy procedure code but LOS < 3 and discharge status = cure

- Cardiovascular surgery procedure code that is not relevant to the hospital capacity

- Brain surgery procedure code but LOS < 3 and discharge status = improved

- Kidney dialysis procedure code but LOS < 5

- Large amount of data in some DRG

- Adjusted RW does not concur with cost

- Other unusual conditions