Introduction
Within diagnosis related group (DRG) systems, long-stay trim points are commonly used to identify patient episodes with extraordinarily long lengths-of-stay, and exclude them from the calculation of the standard (or typical) cost weights.
Long-stay cases would potentially distort the typical cost weights if they were included in their calculation. In addition, long-stay cases often receive special treatment in the cost weights assigned to them. However, identification and exclusion of short-stay, outlier cases in the calculation of typical cost weights is not as common.
This article explores the impact of short-stay outliers on the calculation of cost weights, and the potential use of short-stay trim points in the Case Mix Groups (CMG+) system - Canada's national, acute-care inpatient grouping methodology. Analysis of length-of-stay patterns, and cost profiles of short-stay cases, will identify whether select CMGs (analogous to DRGs) are candidates for redesign.