지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.91 No.2
- 발행연도
- 2016.7
- 수록면
- 66 - 73 (8page)
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초록· 키워드
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Purpose: As several years have passed since the implementation of the Korean diagnosis-related group (DRG) payment system for appendicitis, its early outcomes should be assessed to determine if further improvements are warranted.
Methods: We retrospectively analyzed clinical data from Korean patients who underwent appendectomy, dividing the sample into 2 groups of those who received services before and after implementation of the DRG system. Based on the DRG code classification, patient data were collected including the amount of DRG reimbursement and the total in-patient costs. We subsequently performed univariate and multivariate analyses to identify independent factors contributing to higher total in-patient cost.
Results: Although implementation of the DRG system for appendicitis significantly reduced postoperative length of stay (2.8 ± 1.0 days vs. 3.4 ± 1.9 days, P ＜ 0.001), it did not reduce total in-hospital cost. The independent factors related to total in-hospital cost included patient age of 70 years or more (odds ratio [OR], 3.214; 95% confidence interval [CI], 1.769–5.840; P ＜ 0.001) and operation time longer than 100 minutes (OR, 3.690; 95% CI, 2.007–6.599, P ＜ 0.001). In addition, older patients (≥70 years) showed a nearly 10 times greater relative risk for having a comorbid condition (95% CI, 5.141–20.214; P ＜ 0.001) and a 3.255 times greater relative risk for having higher total in-hospital cost (95% CI, 1.731–6.119, P ＜ 0.001).
Conclusion: It appears that older patients (＞70 years) have greater comorbidities, which contribute to higher inpatient costs. Thus, our study suggests that patient age be considered as a DRG classification variable.
Methods: We retrospectively analyzed clinical data from Korean patients who underwent appendectomy, dividing the sample into 2 groups of those who received services before and after implementation of the DRG system. Based on the DRG code classification, patient data were collected including the amount of DRG reimbursement and the total in-patient costs. We subsequently performed univariate and multivariate analyses to identify independent factors contributing to higher total in-patient cost.
Results: Although implementation of the DRG system for appendicitis significantly reduced postoperative length of stay (2.8 ± 1.0 days vs. 3.4 ± 1.9 days, P ＜ 0.001), it did not reduce total in-hospital cost. The independent factors related to total in-hospital cost included patient age of 70 years or more (odds ratio [OR], 3.214; 95% confidence interval [CI], 1.769–5.840; P ＜ 0.001) and operation time longer than 100 minutes (OR, 3.690; 95% CI, 2.007–6.599, P ＜ 0.001). In addition, older patients (≥70 years) showed a nearly 10 times greater relative risk for having a comorbid condition (95% CI, 5.141–20.214; P ＜ 0.001) and a 3.255 times greater relative risk for having higher total in-hospital cost (95% CI, 1.731–6.119, P ＜ 0.001).
Conclusion: It appears that older patients (＞70 years) have greater comorbidities, which contribute to higher inpatient costs. Thus, our study suggests that patient age be considered as a DRG classification variable.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (13)
참고문헌 신청
Cheng SH. / 2012 / The impacts of DRG-based payments on health care pro vider behaviors under a universal cover age system : a population-based stu dy / Health Policy 107:202~208
Mason A. / 2012 / How well do diagnosis-related groups for appendectomy explain variations in resource use? An analysis of patient-level data from 10 European countries / Health Econ 21(Suppl 2):30~40
Quentin W. / 2012 / Appendectomy and diagnosis-related groups(DRGs) : patient classification and hospital reimbursement in 11 European countries / Langenbecks Arch Surg 397:317~326
Geissler A. / 2012 / 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 / Health Econ 21(Suppl 2):103~115
Ellis RP / 1998 / Creaming, skimping and dumping : provider competition on the in tensive and extensive margins / J Health Econ 17:537~555
Mason A. / 2012 / How well do diagnosis-related groups for appendectomy explain variations in resource use? An analysis of patient-level data from 10 European countries / Health Econ 21(Suppl 2):30~40
Quentin W. / 2012 / Appendectomy and diagnosis-related groups(DRGs) : patient classification and hospital reimbursement in 11 European countries / Langenbecks Arch Surg 397:317~326
Geissler A. / 2012 / 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 / Health Econ 21(Suppl 2):103~115
Ellis RP / 1998 / Creaming, skimping and dumping : provider competition on the in tensive and extensive margins / J Health Econ 17:537~555
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UCI(KEPA) : I410-ECN-0101-2017-514-001019756