Is a Diagnosis-Based Classification System Appropriate for Funding Psychiatric Care in Alberta?

Abstract

Objective This study evaluated the appropriateness of the Refined Group Number (RGN) classification system for funding psychiatric discharges in Alberta. Method Multiple regression was used to calculate the amount of variation explained (R2) in length of stay by RGNs for psychiatric discharges. The distribution of short-stay cases (less than 5 days) was also reviewed. Results The R2 value was higher than those from American studies (0.284 versus less than 0.10) for psychiatric discharges. The length of stay distribution by RGN indicated that the mean was not representative of typical cases. Short-stay cases made up the majority of cases from rural hospitals and had a negative impact on the average length of stay. Conclusions The RGN methodology performed better than diagnosis-based classification systems in the United States. However, there were significant weaknesses in the classification system which suggest that a funding system using the RGN grouper would result in inequitable funding for psychiatric discharges.