DRG prospective, "all payor systems," financial risk, and hospital cost in pulmonary medicine non CC stratified DRGs.

摘要: Previous work by our group had suggested that some pulmonary medicine diagnosis-related (DRGs) did not adequately compensate for patients with multiple complications and comorbidities. Congress has recommended no major changes to DRGs along these lines. The purpose of this study was analyze resource consumption in any the seven noncomplicating conditions (CC), stratified using new DRG prospective "all payor system" effect at hospital. Analysis 858 (Medicare, Medicaid, Blue Cross, commercial insurance) non-CC a three-year period demonstrated more CCs per each generated higher total hospital costs, longer length stay, greater percentage procedures patient, financial risk under payment, outliers, mortality, compared same fewer CCs. Both stay cost patient (adjusted weight index) increased Financial also as accumulated. These findings suggest systems" may be inequitable certain groups or types hospitals vis-a-vis DRGs. Many should numbers equitably reimburse all-payor systems.