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本文引用的文献

1
Identifying potentially preventable complications using a present on admission indicator.使用入院时存在指标识别潜在可预防的并发症。
Health Care Financ Rev. 2006 Spring;27(3):63-82.
2
Hospital performance reports: impact on quality, market share, and reputation.医院绩效报告：对质量、市场份额和声誉的影响。
Health Aff (Millwood). 2005 Jul-Aug;24(4):1150-60. doi: 10.1377/hlthaff.24.4.1150.
3
Clinical redesign using all patient refined diagnosis related groups.使用所有患者细化诊断相关组进行临床重新设计。
Pediatrics. 2004 Oct;114(4):965-9. doi: 10.1542/peds.2004-0650.
4
Paying for quality: providers' incentives for quality improvement.为质量付费：提供者提高质量的激励措施。
Health Aff (Millwood). 2004 Mar-Apr;23(2):127-41. doi: 10.1377/hlthaff.23.2.127.
5
A closer look at all-patient refined DRGs.深入剖析所有患者的精细化诊断相关分组。
J AHIMA. 2002 Jan;73(1):46-50.
6
Medicare program; payments for new medical services and new technologies under the acute care hospital inpatient prospective payment system. Final rule.医疗保险计划；急性护理医院住院患者前瞻性支付系统下新医疗服务和新技术的支付。最终规则。
Fed Regist. 2001 Sep 7;66(174):46901-25.

重新设计医疗保险住院预付费制度以调整对入院后并发症的支付。

Redesigning Medicare inpatient PPS to adjust payment for post-admission complications.

作者信息

Averill Richard F, Vertrees James C, McCullough Elizabeth C, Hughes John S, Goldfield Norbert I

机构信息

3M Health Information Systems, Wallingford, CT 06492, USA.

出版信息

Health Care Financ Rev. 2006 Spring;27(3):83-93.

PMID:17290650
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4194955/
Abstract

Under the Medicare diagnosis-related group (DRG) based inpatient prospective payment system (IPPS), payments to hospitals can increase when a post-admission complication occurs. This article proposes a redesign of IPPS that reduces, but does not eliminate, the increase in payment due to post-admission complications. Using California data that contained a specification of whether each diagnosis was present at admission, and applying a conservative approach to identifying potentially preventable complications, the impact of post-admission complications on DRG assignment was determined. Based on the redesigned IPPS, the increase in Medicare payments due to post-admission complications was reduced by more than one billion dollars annually.

摘要

在基于医疗保险诊断相关分组（DRG）的住院患者前瞻性支付系统（IPPS）下，当入院后出现并发症时，医院获得的支付可能会增加。本文提出了一种IPPS的重新设计方案，该方案可减少但不会消除因入院后并发症导致的支付增加。利用包含每个诊断在入院时是否存在的详细信息的加利福尼亚州数据，并采用保守方法识别潜在可预防的并发症，确定了入院后并发症对DRG分组的影响。基于重新设计的IPPS，因入院后并发症导致的医疗保险支付增加额每年减少了超过10亿美元。