However not all diseases or disorders could be

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MDC corresponding to the organ system involved. However, not all diseases or disorders could be assigned to an organ system-based MDC and a number of residual MDCs were created (e.g., Systemic Infectious Diseases, Myeloproliferative Diseases, and Poorly Differentiated Neoplasms).
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7 For example, the infectious diseases such as food poisoning and Shigella dysentery are assigned to the Digestive System MDC, while pulmonary tuberculosis is assigned to the Respiratory Sys- tem MDC. On the other hand, infectious diseases such as miliary tuberculosis and septicemia, which usually involve the entire body, are assigned to the Systemic Infectious Disease MDC. Once the MDCs were defined, each MDC was evaluated to identify those additional patient char- acteristics which would have a consistent effect on the consumption of hospital resources. Since the presence of a surgical procedure which required the use of the operating room would have a significant effect on the type of hospital resources (e.g., operating room, recovery room, anesthe- sia) used by a patient, most MDCs were initially divided into medical and surgical groups. The medical-surgical distinction is also useful in further defining the clinical specialty involved. Patients were considered surgical if they had a procedure performed which would require the use of the operating room. Since the patient data generally available does not precisely indicate whether a patient was taken to the operating room, surgical patients were identified based on the procedures which were performed. Physician panels classified every possible procedure code based on whether the procedure would normally be performed in the operating room. Thus, closed heart valvotomies, cerebral meninges biopsies and total cholecystectomies would be expected to require the operating room, while thoracentesis, bronchoscopy and skin sutures would not. If a patient had any procedure performed which was expected to require the operating room, that patient would be classified as a surgical patient. Once each MDC was divided into medical and surgical groups, the surgical patients were usually further defined based on the precise surgical procedure performed, while the medical patients were further defined based on the precise principal diagnosis for which they were admitted to the hospital. The general structure of a typical MDC is shown by the tree diagram in figure 1–1. In general, specific groups of surgical procedures were defined to distinguish surgical patients according to the extent of the surgical procedure performed. For example, the procedure groups defined for the Endocrine, Nutritional and Metabolic MDC are amputations, adrenal and pituitary procedures, skin grafts and wound debridement, procedures for obesity, parathyroid procedures, thyroid procedures, thyroglossal procedures, and other procedures relating to Endocrine, Nutri- tional, or Metabolic diseases.
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  • Fall '18
  • Diagnosis-related group, DRGs

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