DO DIAGNOSIS-RELATED GROUPS APPROPRIATELY EXPLAIN VARIATIONS IN COSTS AND LENGTH OF STAY OF HIP REPLACEMENT? A COMPARATIVE ASSESSMENT OF DRG SYSTEMS ACROSS 10 EUROPEAN COUNTRIES

ABSTRACT This paper assesses the variations in costs and length of stay for hip replacement cases in Austria, England, Estonia, Finland, France, Germany, Ireland, Poland, Spain and Sweden and examines the ability of national diagnosis‐related group (DRG) systems to explain the variation in resource...

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Bibliographic Details
Published in:Health economics 2012-08, Vol.21 (S2), p.103-115
Main Authors: Geissler, Alexander, Scheller-Kreinsen, David, Quentin, Wilm
Format: Article
Language:English
Subjects:
Age Factors
arthroplasty
Arthroplasty, Replacement, Hip - economics
Arthroplasty, Replacement, Hip - statistics & numerical data
artificial joint implants
Classification
Comorbidity
cost analyses
Costs
Diagnosis related groups
Diagnosis-Related Groups - statistics & numerical data
DRG
DRGs
Europe
France
Health care expenditures
Health economics
Hip replacement
Hospital Costs - statistics & numerical data
Hospitals
Humans
Ireland
Joint replacement surgery
Length of stay
Length of Stay - economics
Length of Stay - statistics & numerical data
Manycountries
Models, Economic
Postoperative Complications - economics
Regression Analysis
Sex Factors
Studies
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Summary:ABSTRACT This paper assesses the variations in costs and length of stay for hip replacement cases in Austria, England, Estonia, Finland, France, Germany, Ireland, Poland, Spain and Sweden and examines the ability of national diagnosis‐related group (DRG) systems to explain the variation in resource use against a set of patient characteristic and treatment specific variables. In total, 195 810 cases clustered in 712 hospitals were analyzed using OLS fixed effects models for cost data (n = 125 698) and negative binominal models for length‐of‐stay data (n = 70 112). The number of DRGs differs widely across the 10 European countries (range: 2–14). Underlying this wide range is a different use of classification variables, especially secondary diagnoses and treatment options are considered to a different extent. In six countries, a standard set of patient characteristics and treatment variables explain the variation in costs or length of stay better than the DRG variables. This raises questions about the adequacy of the countries' DRG system or the lack of specific criteria, which could be used as classification variables. Copyright © 2012 John Wiley & Sons, Ltd.
ISSN:1057-9230
1099-1050
DOI:10.1002/hec.2848