Muñoz E, Wilkins S, Mallet E, Goldstein J, Sterman H, Wise L
Department of Surgery, Queens Hospital Center, Jamaica, New York.
Urology. 1989 May;33(5):445-8. doi: 10.1016/0090-4295(89)90048-4.
The Diagnostic Related Group (DRG) hospital payment system may be inequitable for certain groups of Medicare patients. This study of 216 Medicare urology patients in the ten non-age stratified urology DRGs demonstrated that patients seventy years of age and older (70+) had higher resource consumption than patients under seventy years of age (70-). Findings were: (1) older patients (70+) had higher total hospital costs (+12,022 per patient) than younger patients (70-) (+9,872 per patient); (2) a longer hospital length of stay (14.2 days vs 11.6 days); (3) financial risk of +1,756 loss per (70+) patient vs +1,309 profit per (70-) patient (p less than 0.05); (4) more diagnoses and procedures per patient, and (5) a higher mortality (4.0% vs 3.3%). These findings suggest that the current DRG scheme may be inequitable vis-a-vis the older urology patient in non-age stratified DRGs, and thus could limit access and quality of care for these patients in the future.
诊断相关分组（DRG）医院支付系统可能对某些医疗保险患者群体不公平。这项针对十个未按年龄分层的泌尿外科DRG中的216名医疗保险泌尿外科患者的研究表明，70岁及以上（70+）的患者比70岁以下（70-）的患者资源消耗更高。研究结果如下：（1）老年患者（70+）的总住院费用（每位患者+12,022美元）高于年轻患者（70-）（每位患者+9,872美元）；（2）住院时间更长（14.2天对11.6天）；（3）（70+）每位患者的财务风险损失为+1,756美元，而（70-）每位患者的利润为+1,309美元（p<0.05）；（4）每位患者的诊断和手术更多，以及（5）死亡率更高（4.0%对3.3%）。这些发现表明，在未按年龄分层的DRG中，当前的DRG方案相对于老年泌尿外科患者可能不公平，因此未来可能会限制这些患者获得医疗服务的机会和医疗质量。
