Muñoz E, Margolis I B, Wise L
Am J Gastroenterol. 1985 Feb;80(2):139-42.
The Tax Equity and Fiscal Responsibility Act will pay hospitals a set price for Medicare patients by one of 467 Diagnostic Related Groups (DRGs). The purpose of this study was to examine one DRG and perform indepth financial analysis in order to develop strategies for cost containment. In addition, we tested the hypothesis that an entity called an identifier (here, the presence or absence of transfusions) could be used to group patients within a specific DRG and demonstrate differences in costs. All patients (n = 46) with gastrointestinal hemorrhage under 70 years old without complications and not requiring surgery (DRG 175) treated at the Long Island Jewish-Hillside Medical Center during 1983 had their hospital charges examined. Total charges (hospital charges exclusive of physician fees) were $3891 +/- 2128 (mean +/- SEM)/patient. Patients requiring transfusion (n = 26) had total charges of $4707 +/- 2292, whereas those not requiring transfusion (n = 20) had total charges of $2765 +/- $1300. Findings in this study are: 1) within a given DRG there is a wide variance of hospital charges, 2) identifiers (in this case transfusion) may be used to clinically aggregate patients with similar resource consumption within a DRG, 3) patients receiving transfusion had 170% greater total charges, 165% greater hematology charges, and 526% greater total blood charges than those not receiving transfusion.
《税收公平与财政责任法案》将根据467个诊断相关分组（DRG）之一，为医疗保险患者向医院支付固定费用。本研究的目的是检查其中一个DRG并进行深入的财务分析，以制定成本控制策略。此外，我们检验了一个假设，即一种称为标识符（在此为是否接受输血）的因素可用于在特定DRG内对患者进行分组，并证明成本差异。对1983年在长岛犹太-希尔赛德医疗中心接受治疗的所有70岁以下无并发症且无需手术的胃肠道出血患者（n = 46，DRG 175）的医院费用进行了检查。总费用（不包括医生费用的医院收费）为每位患者3891 +/- 2128美元（均值 +/- 标准误）。需要输血的患者（n = 26）总费用为4707 +/- 2292美元，而不需要输血的患者（n = 20）总费用为2765 +/- 1300美元。本研究的结果如下：1）在给定的DRG内，医院收费存在很大差异；2）标识符（在此为输血）可用于在DRG内对资源消耗相似的患者进行临床汇总；3）接受输血的患者总费用比未接受输血的患者高170%，血液学费用高165%，总血液费用高526%。
