Rosko M D, Broyles R W
Med Care. 1987 Feb;25(2):88-99. doi: 10.1097/00005650-198702000-00002.
Short-term responses of hospitals to the New Jersey prospective payment system, which uses Diagnosis Related Groups (DRGs) to establish rates of compensation for all payers, were examined in this study. The sample consisted of 84 New Jersey hospitals that were subject to prospective payment and a comparison group of 76 hospitals. Hospitals comprising the comparison group located in eastern Pennsylvania, were reimbursed retrospectively. Regression equations, which included independent variables to control for market supply and demand conditions, were estimated for the cost per admission, cost per day, length of stay; and cases treated. The results indicate that increases in the cost per admission and cost per day were lower (P less than 0.05) in hospitals subject to the all payer DRG system than in those institutions that were reimbursed retrospectively. In addition, the results suggest that most of the cost savings attributed to the New Jersey DRG system are due to a reduction in the average length of stay. The paper concludes with policy implications.
本研究考察了医院对新泽西州预期支付系统的短期反应，该系统使用诊断相关分组（DRGs）来确定所有支付方的补偿率。样本包括84家接受预期支付的新泽西州医院和76家医院组成的对照组。对照组的医院位于宾夕法尼亚州东部，采用回顾性报销。针对每次住院费用、每日费用、住院时间和治疗病例数，估计了包含控制市场供需条件的自变量的回归方程。结果表明，与采用回顾性报销的机构相比，采用全支付方DRG系统的医院每次住院费用和每日费用的增幅更低（P小于0.05）。此外，结果表明，新泽西州DRG系统带来的大部分成本节约归因于平均住院时间的缩短。本文最后得出了政策含义。
