Muñoz E, Chalfin D, Rosner F, Cohen J R, Mulloy K, Wise L
Department of Medicine, Queens Hospital Center, Jamaica, NY.
Oncology. 1988;45(5):401-4. doi: 10.1159/000226651.
This study analyzed hospital resource consumption for 5,065 Medicare patients in 90 noncancer designated medical diagnosis-related groups (DRGs) by whether or not patients had a diagnosis of a malignancy (i.e. cancer). Patients with cancer had greater hospital resource utilization than noncancer patients in these medical DRGs. Cancer patients had a greater percentage of outliers (p less than 0.02), twice the financial loss under DRGs, more diagnoses (p less than 0.001) and procedures (p less than 0.0001) per patient, and a greater mortality (p less than 0.0001) than noncancer patients. These findings raise the question of the equity of DRG payment vis-à-vis medical cancer patients in many medical DRGs, and whether the DRG scheme may provide disincentives to treat some elderly Americans with cancer.
本研究分析了90个非癌症指定医疗诊断相关组（DRG）中5065名医疗保险患者的医院资源消耗情况，这些患者根据是否患有恶性肿瘤（即癌症）进行分组。在这些医疗DRG中，癌症患者的医院资源利用率高于非癌症患者。癌症患者的异常值百分比更高（p小于0.02），DRG下的财务损失是后者的两倍，每位患者的诊断（p小于0.001）和手术（p小于0.0001）更多，死亡率也高于非癌症患者（p小于0.0001）。这些发现引发了一个问题，即在许多医疗DRG中，针对癌症患者的DRG支付是否公平，以及DRG方案是否可能不利于治疗一些患有癌症的美国老年人。
