Potential loss of revenue due to errors in clinical coding during the implementation of the Malaysia diagnosis related group (MY-DRG®) Casemix system in a teaching hospital in Malaysia

Abstract Background The accuracy of clinical coding is crucial in the assignment of Diagnosis Related Groups (DRGs) codes, especially if the hospital is using Casemix System as a tool for resource allocations and efficiency monitoring. The aim of this study was to estimate the potential loss of income due to an error in clinical coding during the implementation of the Malaysia Diagnosis Related Group (MY-DRG®) Casemix System in a teaching hospital in Malaysia. Methods Four hundred and sixty-four (464) coded medical records were selected, re-examined and re-coded by an independent senior coder (ISC). This ISC re-examined and re-coded the error code that was originally entered by the hospital coders. The pre- and post-coding results were compared, and if there was any disagreement, the codes by the ISC were considered the accurate codes. The cases were then re-grouped using a MY-DRG® grouper to assess and compare the changes in the DRG assignment and the hospital tariff assignment. The outcomes were then verified by a casemix expert. Results Coding errors were found in 89.4% (415/424) of the selected patient medical records. Coding errors in secondary diagnoses were the highest, at 81.3% (377/464), followed by secondary procedures at 58.2% (270/464), principal procedures of 50.9% (236/464) and primary diagnoses at 49.8% (231/464), respectively. The coding errors resulted in the assignment of different MY-DRG® codes in 74.0% (307/415) of the cases. From this result, 52.1% (160/307) of the cases had a lower assigned hospital tariff. In total, the potential loss of income due to changes in the assignment of the MY-DRG® code was RM654,303.91. Conclusions The quality of coding is a crucial aspect in implementing casemix systems. Intensive re-training and the close monitoring of coder performance in the hospital should be performed to prevent the potential loss of hospital income

Synthesis of lithium intercalation oxides based manganese and copper by the sol-gel method

The current generation of lithium-ion batteries uses LiCoO2 or LiNiO2 as cathodes. In contrast to LiCoO2 and LiNiO2 systems, it is easy to synthesize a Mn-based cathode that contains more than one Li per formula unit. LiCuO2 is also a promising electrode material for lithium batteries and it seems to be an attractive candidate as a new electrode material. LiCoO2 and graphite have layered structures and LiMn2O4 has a tunnel-like framework and both structures are useful for the insertion and de-insertion of lithium guest ions into host materials with minimal physical alteration of the host structure. Therefore, in this work attempts have been made to mix both transition metals of copper and manganese to form mixed Lithium manganese copper oxide as cathodic materials for lithium batteries, and the lithiated intercalation cathode materials (LiM2O4, M=Mn, Cu) were synthesized by the sol gel method. The elements, Mn and Cu were chosen because a Mn-based cathode can easily accommodate more than one lithium per formula unit while Cu has an advantage of lower cost and safety. Various ratios of Mn and Cu acetates, lithium hydroxides were used as starting materials with tartaric acid as the gelating agent. The dried samples were calcined at 800 oC. Structural changes were observed when Cu was introduced into LiMn2O4. Mixed oxides of Li2MnxCuyOz were formed. The structure of the calcined materials was characterized by XRD, EDX and SEM. The XRD patterns for LiM2O

Astronomy outreach programs with STEM ambassadors under the C3AOL project

This paper reports our experiences in conducting outreach astronomy programs involving high school students and the general public. These programs are part of an interdisciplinary research project entitled Cross-cultural Computer supported Collaborative Learning for Student Capacity Building in Multifaceted Competencies through Astronomy Online Labs (C3AOL). As part of this research project, two selected undergraduate Physics students were named as STEM ambassadors and tasked in disseminating astronomical facts and concepts via outreach activities, thus consolidating their knowledge, creativity, and identity as STEM ambassadors. The STEM ambassadors have planned and conducted an Astronomy outreach program with high school students from the Pusat PERMATApintar Negara (currently known as Pusat GENIUS@Pintar Negara), UKM. This was followed by a public stargazing session at the National Planetarium, Kuala Lumpur that involved planetary and lunar eclipse observations. This project provided a valuable opportunity for the STEM ambassadors to convey astronomical knowledge effectively and interestingly in multiple contexts, whether amongst their peers or junior students, or even with the general public. A short-term impact of this project is the diffusion of their knowledge and enthusiasms in Astronomy to high school students as well as the general public through outreach programs such as dialogues session and talks at space centers and experience sharing via social media

Adsorption characteristics of bisphenol a onto low-cost modified phyto-waste material in aqueous solution

The potential of agricultural waste materials for the removal bisphenol A (BPA) from aqueous solution was investigated. BPA is an endocrine-disrupting compound (EDC) used mainly in the plastic manufacturing industry. It may be hazardous to humans and animals because of its estrogenic activity. Agricultural wastes are sustainable adsorbents because of their low cost and availability. Hence, this study investigated the removal of BPA from water by adsorption onto treated coir pith, coconut shell and durian peel. The adsorption of BPA from water onto adsorbent was evaluated using field emission scanning electron microscopy (FESEM), Fourier transform infrared spectroscopy (FTIR), and Brunauer-Emmett-Teller (BET). The effects of morphology, functional groups, and surface area on adsorption before and after pretreatment with sulfuric acid and reaction were investigated, and it was found that the treated adsorbent were able to remove BPA. Carbonyl and hydroxyl groups had appear in large number in FTIR analysis. The present study indicates that coir pith had removed 72 % of BPA with adsorption capacity of 4.308 mg/g for 24 h, followed by durian peel (70 %, 4.178 mg/g) and coconut shell (69 %, 4.159 mg/g). The results proved that these modified phyto-waste were promising materials as alternative adsorbent for the removal of BPA from aqueous solutio