co-opting physicians to regulate fee-for-service (ffs) payment is more feasible and simpler to administer than capitation, diagnosis-related groups (drgs) and pay-for-performance. the key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. adherence to these regulations must be strictly audited in order to c...

The excitatory amino acid glutamate plays an important role in the development of neuronal sensitization and the ionotropic N-methyl-d-aspartate receptor (NMDAR) is one of the major receptors involved. The objective of this study was to use a cat model of gastroesophageal reflux disease (GERD) to investigate the expression of the NR1 and NR2A subunits of NMDAR in the vagal and spinal afferent f...

Many hospitals in the 1990s many hospitals were accused of "upcoding" patient diagnostic related groups (DRGs) to increase Medicare reimbursements. We find that between 1989 and 1996, the percentage point share of the most generous DRG for pneumonia and respiratory infections rose by 10 points among not-for-profit hospitals, 23 points among for-profit hospitals, and 37 points in hospitals conve...

STUDY OBJECTIVES We hypothesized that continuous, automatic turning utilizing a patient-friendly, low air loss surface would reduce the incidence of early ICU pneumonia in selected groups of critically ill medical patients. DESIGN Prospective, randomized, controlled clinical trial. SETTING Medical ICU of a large community teaching hospital. PATIENTS One hundred twenty-four critically ill ...

PURPOSE Previous studies have examined the effects of hospitalists in urban academic hospitals. We compared the outcomes of patients treated by hospitalists with those of patients treated by internists at a 647-bed rural community hospital. SUBJECTS AND METHODS The 443 patients in the hospitalists' 10 most common diagnosis-related groups (DRGs) were compared with 1,681 patients in the same DR...

OBJECTIVE This study evaluated the institutional impact of a substance abuse consultation service in a hospital setting. METHOD Treatment and matched comparison groups were compared on five outcome variables: length of stay, total cost, reimbursement, readmission, and appropriateness of care. The treatment group consisted of patients with discharge diagnoses falling into targeted Diagnostic R...

In France, cancer care is evolving to the design of regional networks, so as to coordinate expertise, services and resources allocation. Existing information systems along with data-mining tools can provide better knowledge on the distribution of patient flows. We used one year data of the French Diagnosis Related Groups (DRGs) based system to perform our analysis. Formal Concept Analysis has b...

To purchase reprints, contact The InnoVision Group, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 809-2273 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, [email protected]. institution. The resources required by these patients can greatly exceed the reimbursements for their diagnosis-related groups (DRGs). A 1992 study by Bach et al showed that charges associated with LTV patient...

Forensic practice fees, billing, and collection procedures are quite different from those in general psychiatry. Most forensic practices have far fewer "clients," and individual bills are usually larger. Collections are usually better (and less frequently discounted) in forensic practice, and resolving billing disputes is far more straightforward. Medicare, Medicaid, other insurance coverage, p...

Introduction Flat rates based on Diagnosis Related Groups (DRGs) are being introduced in a growing number of countries to remunerate acute inpatient treatment. In doing so, it will have to be decided – among other things – whether inpatient emergency services should be remunerated separately from the DRG flat rates or as part of them. Without separate remuneration, there may be a perception, or...