Munoz E, Sterman H, Cohen J, Goldstein J, Margolis I B, Wise L
Department of Surgery, Queens Hospital Center, New Hyde Park, New York.
Ann Surg. 1988 Mar;207(3):305-9. doi: 10.1097/00000658-198803000-00013.
The purpose of this study was to analyze resource consumption in the 147 non-complicating condition-stratified surgical diagnostic related groups (DRGs). Analysis of 2647 surgical patients in these non-CC-stratified surgical DRGs demonstrated that patients with more CCs per DRG generated higher total hospital costs, a longer hospital length of stay, a greater percentage of procedures per patient, financial risk under DRG payment, more outliers, and a higher mortality rates than patients in these same DRGs with fewer CCs. These findings suggest that the current DRG classification system may be inequitable to certain groups of patients or types of hospitals vis-à-vis the non-CC-stratified surgical DRGs. Financial disincentives to treat these patients may affect both their access and quality of care in the future.
本研究的目的是分析147个非并发症分层手术诊断相关组(DRG)中的资源消耗情况。对这些非并发症分层手术DRG中的2647例手术患者进行分析后发现,每个DRG中合并症(CC)较多的患者比同一DRG中CC较少的患者产生了更高的总住院费用、更长的住院时间、每位患者更高的手术比例、DRG付费下的财务风险、更多的高费用病例以及更高的死亡率。这些发现表明,相对于非并发症分层手术DRG而言,当前的DRG分类系统可能对某些患者群体或医院类型不公平。未来,治疗这些患者的经济激励不足可能会影响他们获得医疗服务的机会和医疗质量。