HOW WELL DO DIAGNOSIS-RELATED GROUP SYSTEMS GROUP BREAST CANCER SURGERY PATIENTS?-EVIDENCE FROM 10 EUROPEAN COUNTRIES

ABSTRACT We analysed patient‐level data (n = 72 235) from 563 hospitals in 10 European countries to assess the ability of national diagnosis‐related group (DRG) systems to account for patient‐level variation in cost or lengths of stay of breast cancer surgery patients against a standard set of patie...

Full description

Saved in:
Bibliographic Details
Published in:Health economics 2012-08, Vol.21 (S2), p.41-54
Main Author: Scheller-Kreinsen, David
Format: Article
Language:English
Subjects:
Accounting
Age Factors
Breast cancer
Breast Neoplasms - epidemiology
Breast Neoplasms - surgery
Cancer surgery
Classification
Diagnosis related groups
Diagnosis-Related Groups - statistics & numerical data
DRGs
Europe
Europe - epidemiology
Female
Health care expenditures
Health economics
Hospital Costs - statistics & numerical data
hospital financing
Hospitals
Humans
Length of stay
Length of Stay - economics
Length of Stay - statistics & numerical data
Manycountries
Mastectomy - economics
Models, Economic
Patients
payment
Postoperative Complications - economics
Studies
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ABSTRACT We analysed patient‐level data (n = 72 235) from 563 hospitals in 10 European countries to assess the ability of national diagnosis‐related group (DRG) systems to account for patient‐level variation in cost or lengths of stay of breast cancer surgery patients against a standard set of patient characteristics, treatment and quality variables. We find that European DRG systems use very different types of classification variables and numbers of DRGs (range: 3–7) to classify these patients. In 6 of 10 countries, the set of patient characteristics, treatment and quality variables, which we were able to define across countries, perform better than the set of national DRGs in accounting for patient‐level variation in resource consumption. Moreover, there appear to be factors that are consistently significant determinants of cost/length of stay of breast cancer surgery cases but are not, or at least not fully, considered in European DRG systems. Our results therefore raise concerns as to whether all systems rely on the most appropriate classification variables. In several countries, policymakers should reevaluate the appropriateness of their DRG algorithm for breast cancer surgery and of specific DRG weights. Copyright © 2012 John Wiley & Sons, Ltd.
ISSN:1057-9230
1099-1050
DOI:10.1002/hec.2832