[Computerized information system support in continuous quality improvement in hospital care]

DRG (Diagnosis Related Groups) classification system requests much of medical and financial data from patients record. We also need comprehensive Clinical Information System with computer database to manage such system. In our research we were using HCFA (Health Care Financing Administration) and AN-DRG (Australian National-DRG) methodology for DRG classification. We also used ICD 10-Revision for diagnosis coding. We have chosen ORL Clinic for DRG classification because of two reasons: 1) They treat two basic types of patients medical and surgical and 2) They had pretty good sorted patients' records. Our base for DRG classification was 1997 year. During our research we found many deficiencies in patient records in both its parts: medical and financial. Since all records were processed and stored manually, financial data didn't exist. So we had to use other ways for direct and indirect costs allocation (for Prospective Payment System purpose). In 1998 we processed 680 patient records (treated in 1997), and made DRG classification putting all 680 patients' records into 183 DRG: 47 medical and 136 surgical. This is so called CASE-MIX of the ORL Clinic for year 1997. DRG classification we made at Tuzla ORL Clinic was identical with HCFA DRG classification system in 92%.