This paper develops a model in which physicians choose the level of services to be provided to their patients. We show that if physicians undervalue benefits to patients relative to hospital profits, prospective payment, a system in which hospitals receive a payment dependent on the diagnosis-related group within which a patient falls, can lead to too few services being provided. In contrast, a...

INTRODUCTION AND OBJECTIVES Cardiac care is one of the most important and rapidly rising costs in the healthcare system. Therefore, any improvement can produce significant savings. We analyze the evolution of classical clinical effectiveness indexes in a cardiac unit after a change in clinical management. METHODS We reviewed overall clinical effectiveness indexes and the most significant DRGs...

BACKGROUND Many studies have demonstrated a rise in computed tomography (CT) utilization in abstract children's hospitals. However, CT utilization may be declining, perhaps due to awareness of potential hazards of pediatric ionizing radiation, such as increased risk of malignancy. Th e objective is to assess the trend in CT utilization in hospitalized children at freestanding children's hospita...

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 introduction of prospective payment system (PPS) based on diagnostic related groups (DRGs) has had a significant impact on hospitals. To determine the impact of PPS on nursing homes, the authors studied the activity of a Veterans Administration teaching nursing home (admissions, acute hospital transfers, and discharges) during 1 year preceding implementation of DRGs and for 3 consecutive ye...

ABSTRACT Background. Previous economic studies have compared the cost effectiveness of different heparins used as prophylaxis against venous thromboembolism (VTE) in medical patients at risk. These pharmacoeconomic evaluations have revealed cost benefits of enoxaparin over unfractionated heparin (UFH). However, these modeling studies generally do not use “real-life” hospital data to calculate t...

OBJECTIVE To analyze the frequency and length of hospital stays as well as the frequency of diabetes-associated outpatient visits of children and adolescents with type 1 diabetes before and after the introduction of DRGs (diagnosis-related groups) in German hospitals. METHODS For this prospective cohort study, data from 2000 (before introduction of DRGs) to 2008 (after introduction) was extra...