On the use of administrative databases to support planning activities: a comment

Sir,The paper by Fantini et al. 1 rightly stresses the importance in health care planning of identifying centres that treat more severe (complex) cases. However, in their evaluation of the ability of two software packages, Medicare Diagnosis Related Groups (Medicare DRG) and All Patient Refined Diagnosis Related Groups (APR-DRG), to achieve this objective, they omit to mention that the APR-DRG software incorporates into its risk adjustment modules discharge diagnosis codes representing all conditions treated during the hospitalization, regardless of when they occurred, and including late, ‘near death’ events.2This approach may be understandable, since the APR-DRG software, similar to most discharge …