Taube C, Lee E S, Forthofer R N
Med Care. 1984 Jul;22(7):597-610. doi: 10.1097/00005650-198407000-00002.
On October 1, 1983, Medicare began paying general hospitals by a prospective payment system based on DRGs. Psychiatric settings are exempted automatically or by request. By January 1985, however, a decision is required on how to integrate psychiatric settings into this system. This article provides an empirical analysis of the current DHHS DRGs categories for mental disorders. Current mental disorder DRGs and alternate DRGs examined here explain less than 3-12% of the variation in psychiatric length of stay. This is in contrast to 30-50% explained variation for other disorders. Alternatives and policy implications are discussed.
1983年10月1日,医疗保险开始通过基于诊断相关分组(DRGs)的前瞻性支付系统向综合医院支付费用。精神科机构自动或应要求被豁免。然而,到1985年1月,需要就如何将精神科机构纳入该系统做出决定。本文对美国卫生与公众服务部(DHHS)当前精神障碍的诊断相关分组类别进行了实证分析。此处研究的当前精神障碍诊断相关分组和替代诊断相关分组解释的精神科住院时间变化不到3%至12%。这与其他疾病30%至50%的解释变异形成对比。文中讨论了替代方案和政策影响。