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DRG价格中是否存在压缩现象?

Is compression occurring in DRG prices?

作者信息

Lave J R

出版信息

Inquiry. 1985 Summer;22(2):142-7.

PMID:3159670
Abstract

Many analysts believe that the prices of truly high cost DRGs are set low relative to their actual costs whereas the prices of truly low cost DRGs are set high relative to their costs. To test whether such "compression" is occurring, I examined the algorithm that the Health Care Financing Administration used to create its DRG pricing structure. I then compared the HCFA algorithm with the more refined weighting systems used by Maryland and New Jersey to create their DRG payment systems. I found that compression is indeed occurring in the Medicare system relative to both the New Jersey and the Maryland systems. This compression will assume special urgency for some hospitals when the standardized national DRG payment system is phased in or if stringent limits are placed on the overall rate of increase in DRGs.

摘要

许多分析人士认为,真正高成本诊断相关分组(DRG)的价格相对于其实际成本被定得过低,而真正低成本DRG的价格相对于其成本被定得过高。为了检验这种“压缩”是否正在发生,我研究了医疗保健财务管理局用于创建其DRG定价结构的算法。然后,我将医疗保健财务管理局(HCFA)的算法与马里兰州和新泽西州用于创建其DRG支付系统的更精细加权系统进行了比较。我发现,相对于新泽西州和马里兰州的系统,医疗保险系统中确实存在这种压缩现象。当标准化的全国DRG支付系统逐步实施,或者如果对DRG的总体增长率设置严格限制时,这种压缩对一些医院来说将具有特殊的紧迫性。

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