IDRT - Integrated Data Repository Toolkit
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Contributors: Igor Engel, Sebastian Mate, Jan Christoph, Hans-Ulrich Prokosch, Thomas Ganslandt 

TODO TG: content

Background

The §21 dataset is a German benchmarking dataset mandated by the law on hospital reimbursement (Paragraph 21: "Übermittlung und Nutzung von Daten - des Gesetzes über die Entgelte für voll- und teilstationäre Krankenhausleistungen" (Krankenhausentgeltgesetz - KHEntgG)). It is primarily used to derive the German inpatient billing system based on Diagnosis Related Groups (DRGs) and has to be provided by every German hospital on a yearly basis. It is thus supported by all hospital patient administration and billing systems established in Germany. Due to its standardization and high availability, the §21 dataset has been established as a source dataset for benchmarking projects and other regional and national collaborations. It is thus also an ideal candidate for a "quick win" i2b2 implementation, as its format is well-structured and documented and it can be produced easily by any German hospital, rapidly providing a functional prototype with local data.

It should be noted, however, that the §21 dataset is primarily reimbursemenet-oriented, which may limit its usefulness in the research area.

The §21 dataset is based on a standard delimited ("CSV") format with the following files and contents of interest, among others (full specification in German language)

  • fall.csv: encounter-related data and patient demographics
  • fab.csv: transfer history within encounter
  • icd.csv: diagnosis codes based on ICD10-GM catalog (GM: German Modifications)
  • ops.csv: procedure codes based on German OPS medical procedures catalog
  • drg.csv: diagnosis related group codes

The drg.csv file is not part of the standard §21 dataset, but can be generated from the other files using a certified DRG grouping software. 

The §21 dataset itself does not contain the relevant terminologies - all coded items are represented just as their codes (e.g. an ICD diagnosis code). Thus, the terminologies have to be imported and joined to achieve an interpretable dataset.

Concept

As the §21 is provided in CSV format, the standard CSV extraction capabilities of the IDRT platform can be used, either through the Import and Mapping Tool (IMT) or through direct use of the underlying Talend ETL jobs. The IDRT §21 provides ready-to-use configuration files for the full set of §21 source data files, with versions adapted to the several releases of the §21 specification over the past years.

Since the §21 files are linked together only by an encounter number, the patient number has to be added in order to achieve full compatibility with the IDRT CSV import module. This addition of patient numbers is carried out in a pre-processing step before the actual import. 

After the initial import, the §21 dataset would be represented in i2b2 in a very low-level format still close to the source CSV files: all coded items would just be displayed with their codes (and not the related names), and items that relate to large, hierarchical terminologies (e.g. ICD diagnosis classification) would be presented as very long lists. In a final post-processing step, the relevant standard terminologies (in this case ICD, OPS and G-DRG) as well as §21-specific codelists (e.g. for admission type, clinical service) are imported and merged with the dataset to provide a well-structured and human-readable hierarchical representation.

Import §21

Name

Description

Truncate i2b2 Project?

If you check this, the project will be truncated before the data is uploaded.

Truncate Previous Queries?

This will truncate the previous queries tables.

Set patient_count after import

This will fill the c_totalnum column.

P21 Folder

Here you can select the folder that contains all P21 files you want to upload.

P21 Version

Here you can select the corresponding version for your P21 dataset.

Date Pattern

Select the date pattern used in the P21 Files.

Save Settings?

This will save the settings for the next import. Note: The truncate checks are never saved.

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