VAHI has made a decision to remove the death in low mortality diagnosis-related groups (DRGs) measure from its reports pending a full review.
The death in low mortality DRGs measure was developed by the Australian Commission on Safety and Quality in Health Care as part of their suite of core hospital-based outcome indicators. It is intended to capture deaths resulting from episodes of care that are coded to Diagnosis Related Groups that have a very low chance of death (i.e. less than 0.5% based on historical data) so that those cases can be reviewed to assess whether quality of care played a role in the outcome.
The measure was initially reported in the PRISM report and was part of the set of quality and safety measures recommended in Targeting zero for monitoring. In 2017-18 it was included in the Statement of Priorities for health services and as such was reported in VAHI's Monitor, Inspire and Board safety and quality report, as well as the Risk Assessment Tool.
Feedback from health services and the Clinical Reporting and Measurement Committee
VAHI is committed to reporting measures that are important to the healthcare system. We are also committed to responding to feedback from stakeholders.
Health services and clinicians have provided consistent feedback to VAHI that the death in low mortality DRGs measure is identifying deaths that are not necessarily associated with low mortality conditions. Some health services have investigated their results and found a reasonably high proportion to be 'false positives'. This means that when the health services are reviewing the cases that have been flagged, they are finding such things as patients who are palliative on admission to hospital are being captured by the current methodology. These patients cannot be reasonably considered as "unlikely" deaths.
VAHI review of death in low mortality DRGs measure
VAHI will work with health services, clinicians, the Department of Health and Human Services and Safer Care Victoria (SCV) to refine the current methodology and determine future options for a more robust measure. We are planning a forum with experts to inform the development of this and other mortality indicators.
VAHI and SCV have agreed that the measure should not be reported in its current state while the methodological review is underway. This means that it will not be included in the Statement of Priorities for 2018-19.
VAHI will continue to monitor the measure using the existing methodology, and will work with SCV to respond where issues arise.
Once a revised methodology has been developed and tested, it could be re-introduced into the appropriate reporting products. The revised version of the measure is expected to be ready in early 2019.
Page last updated: 12 Jun 2018