How does it work?

How does it work?

Luxembourg's DCSH system for documenting hospital stays works in the same way as the system in Belgium. This means of operation was defined in agreements signed in June 2016 between the CNS (National Health Fund), the FHL (Federation of Luxembourg Hospitals) and the AMMD (Association of Doctors and Dentists), and in the Law on hospitals of 8 March 2018.

In particular, this law requires health needs to be assessed, and for hospitals to supply the data needed to produce the health map. In order to analyse its activity, each establishment must produce clinical records for each patient.

In practice, doctors produce the medical reports pertaining to hospital stays, enter up the ICD-10-CM and ICD-10-PCS codes for diagnoses and procedures and close the patient file within a recommended timescale.

These records must be kept:

  • By all hospitals with intensive care units and specialist establishments,
  • For shorter hospital stays and outpatient care for which a hospital bed was needed,
  • For all patients, irrespective of whether or not they belong to the CNS,
  • For any procedure that meets at least one of the following criteria:
    • Surgical procedure,
    • Procedure involving risks corresponding to anaesthesia,
    • Procedure involving risks resulting from the procedure itself,
    • Procedure requiring specialist training.

DIM departments (Documentation et information médicale – Documentation and Medical Information) enter the ICD-10 codes and check the quality of the medical and administrative data. Any amendments made to codes by the staff of the DIM department will require approval from the treating physician.

The 3M DRGfinder software then groups the hospital stays into clusters, based on their consumption of resources, severity and risk of patient mortality.

The grouped codes and data are stored in a centralised database for each hospital and, after pseudonymisation, exported for the State's use. Annual external audits are performed on a random sample in order to check the quality of the data.

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