Financial Risk, Hospital Cost, Complications, and Comorbidities in Surgical Noncomplication- and Noncomorbidity-stratified Diagnostic Related Groups

• Published in: Annals of surgery 1988-03, Vol.207 (3), p.305-309
• Main Authors: MUOZ, ERIC, STERMAN, HARRIS, COHEN, JON, GOLDSTEIN, JONATHAN, MARGOLIS, IRVING B, WISE, LESLIE
• Format: Article
• Language: English
• Subjects: Academic Medical Centers - statistics & numerical data; Analysis of Variance; Biological and medical sciences; Costs and Cost Analysis; Diagnosis-Related Groups - economics; Hospital Bed Capacity, 500 and over; Humans; Medical sciences; Medicare - economics; Morbidity; New York City; Public health. Hygiene-occupational medicine; Surgical Procedures, Operative - classification; Surgical Procedures, Operative - economics; Utilization Review
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-198803000-00013

The purpose of this study was to analyze resource consumption in the 147 non-complicating condition—stratified surgical diagnostic related groups (DRGs). Analysis of 2647 surgical patients in these non-CC-stratified surgical DRGs demonstrated that patients with more CCs per DRG generated higher total hospital costs, a longer hospital length of stay, a greater percentage of procedures per patient, financial risk under DRG payment, more outliers, and a higher mortality rates than patients in these same DRGs with fewer CCs. These findings suggest that the current DRG classification system may be inequitable to certain groups of patients or types of hospitals vis-a-vis the non-CC-stratified surgical DRGs. Financial disincentives to treat these patients may affect both their access and quality of care in the future.