This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Munoz, E. Articles by Wise, L. Search for Related Content PubMed Articles by Munoz, E. Articles by Wise, L. Social Bookmarking                         What's this?

The DRG Prospective Payment System, Age, Resource Consumption, and Outcome for Peripheral Vascular Surgical Patients

Division of Peripheral Vascular Surgery and the Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY

Edgar Borrero

Division of Peripheral Vascular Surgery and the Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY

Jonathan Goldstein

Division of Peripheral Vascular Surgery and the Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY

Katherine Mulloy

Division of Peripheral Vascular Surgery and the Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY

John Chang

Division of Peripheral Vascular Surgery and the Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY

Leslie Wise

Division of Peripheral Vascular Surgery and the Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY

The federal Medicare DRG pro spective payment system as entered its sixth year, with no major adverse effect so far on American health care regarding either access to or quality of surgical care. The authors ana lyzed hospital resourc consumption and outcome by age for peripheral vascular surgical patients from Ja nuay 1, 1985, through March 31, 1986, at a large academic medical center using the DRG format. Total costs (exclusive of MD fees) for the 211 peripheral vascular surgical pa tients studied were $2,933,623. Mean hospital cost per patient, hospital length of stay, percent of outliers, and mortality were higher for pa tients seventy-five years of age and over as compared with younger pa tients. DRG case-mix index and the number of procedures per patient was also higher for these older pa tients.

This study demonstrated that un der prospective payment systems (ie, DRG reimbursement) financial risk was higher for patients seventy-five years of age and over, as were hospi tal length of stay, the number of pro cedures per patient, and mortality. These data suggest that current DRG reimbursement may provide finan cial disincentives to treat elderly pe ripheral vascular surgical patients. As government continues to decrease DRG hospital payment for these pa tients relative to hospital costs, both their access to and quality of surgical care could be jeopardized in the fu ture.

Vascular and Endovascular Surgery, Vol. 23, No. 1, 43-50 (1989)
DOI: 10.1177/153857448902300107


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?