Most appropriate OMOP table to house DRG information

Vocabulary Users
1

Hello,

I am trying to map DRG information available in the source data over to an appropriate v5 OMOP table. I noticed that VISIT_COST, PROCEDURE_COST, DRUG_COST and DEVICE_COST have been phased out. Are we meant to use just the COST table to store DRG related information?

Also where can I obtain documentation on the COST table?

Regards,
Vimala

2

@Vimala_Jacob:

Yes. Here.

3

@Christian_Reich - it doesn’t look like the DRG field has been added to the Cost table yet because we still have to vote on whether the DRG field will be added (per our working group page http://www.ohdsi.org/web/wiki/doku.php?id=documentation:next_cdm). @Vimala_Jacob - the plan is to add the DRG field to the Cost table after it is voted in (which I suspect it will). Our next working group meeting is the beginning of September and I hope the documentation would be amended at that point. If you absolutely need to add the DRG information immediately, the current protocol is to add it to the Observation table.

4

Ouch. Yes, you are right. We haven’t officially added it. But we made the decision that we would, and since the DRG has no other place (other than in the OBSERVATION) it’s about time. Should we just add it?

5

I’m ok with “just adding it”, but I was going to vote for it on the next meeting anyways. Forgive me, I know we went through this on a previous meeting, but I do not know the proper protocol on accepting CDM changes. I do not want @rimma or anyone else from the CDMWG to get upset that we are making changes without going through due process. Or am I being too strict on this whole thing?

6

Oh no!!! Don’t get @rimma upset! :smile:

I think we did rubber stamp it, but let me ask her one more time in case I don’t remember correctly.

3 Likes
7

@Christian_Reich knows, don’t get me upset :smile:

We did accept the proposal as is. It is just a matter of adding this to the documentation and the table DDL.

The unresolved aspect is handling of the changes in the DRG vocabulary versions. This will be discussed separately.

1 Like
8

Hi all,

  1. Has this been voted/agreed on, that DRG data now move to the cost table? It appears to have been documented here here and here but in my current vocab (20161218) DRG codes are associated with the observation domain (select distinct domain_id from concept where vocabulary_id = ‘DRG’). Is the idea now the cost table will be the only place where a DRG code is associated with a visit?

  2. My use case includes MS-DRG (vocabulary_id=‘DRG’), MS-DRG-MDC (vocabulary_id=‘MDC’), and APR-DRG (with no associated vocabulary_id in the vocabulary table that I can see) records. For the meantime I plan to move MS-DRG-MDC and APR-DRG records to the observation table, but it seems peculiar to put some DRG-related codes in the cost table and others in observation. Can you recommend a best course of action or point out what I’m misunderstanding?

Thanks,
Jamie

9

Hi @jweave17. My impression is that all DRG information should be stored in the Cost table. The concept_id for the DRG should be stored in the cost.drg_concept_id field. It looks like the domainid was not update to the cost table designation in the most recent vocabularies.

However, I believe the cost table only stores one DRG per cost, though I don’t think that will be an issue for you. The MS-DRG-MDC code is just a category that the MS-DRG is located in. So I’m not sure why you want to add the MS-DRG-MDC information into the CDM - seems like duplication. AP-DRGs are codes associated with non-Medicare patients and MS-DRG codes are associated with Medicare patients. So you shouldn’t get both codes for one patient. SO really there should only be one DRG code (regardless of type) for one inpatient bill. But if you are going to store the APR-DRG in the Cost table, then the concept_id should have a domainid of “cost”… well and we should really add the APR-DRG into the vocabularies.

This sounds like a job for @Christian_Reich :smile:

10

@jenniferduryea do you have the links to APR-DRG (where we can get the data to put into the vocabs)?

11

@aostropolets No I do not. I am assuming, @jweave17, the original poster, has some access to APR-DRG lists since he was the one who mentioned it first :laughing:

12

There was a recommendation from THEMIS to answer this “where do you store DRGs?”

RECOMMENDATION
DRGs should be stored in the COST table using the DRG_CONCEPT_ID and DRUG_SOURCE_VALUE columns.

ACTION
Add this under the CDM Wiki FAQ.
Vocabulary team to add the APR-DRG into CONCEPT and change the domain to ‘Cost’.

13

Hoping to resurrect this discussion as our network would also benefit from having the APR-DRG vocabulary included. (Please let me know if this is not the correct forum and I would be happy to create a new issue)

It is supported by 3M and is available here:
https://support.3mhis.com/app/answers/detail/a_id/9907/~/definitions-manuals

In our source we have versions 27-35, so we would need both the ICD9 and ICD10 versions.

@jenniferduryea @jweave17 @Christian_Reich @ericaVoss

14

@burrowse If you wouldn’t mind creating a new forum post for adding APR-DRGs, that would be great. It looks like @ericaVoss posted a THEMIS action for this, pretty much resolving this thread. But, we can hop on the new issue with thoughts. Thanks for bringing this up!

15

Thanks!! I opened another post here Adding APR-DRGs to the vocabulary