BACKGROUND Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. METHODS Two-center, standardi...

The Diagnosis-Related Groups (DRGs), is a method that identifies patients with similar resources use, based on statistical evaluation of hospital records. Statistics provide the Diagnosis related consumed resources and, thus, they enable the calculation of an average patient’s case-cost. On the basis of the Hospital activity levels and case mix, the health authorities can allocate the annual ho...

This paper examines the quality of routinely collected information in an Iranian hospital in a trial of casemix classification. Australian Refined Diagnosis Related Groups (AR-DRG) were used to classify patient episodes. There were 327 DRGs identified, of which 20% had only 1 case. The grouper program identified invalid records for 4% of total separations. Approximately 4.5% of cases were class...

The adoption by Medicare in 1983 of prospective payment using diagnosis-related groups (DRGs) has stimulated research to develop case-mix grouping schemes that more accurately predict resource consumption by patients. In this article, the authors explore a new method designed to improve case-mix classification for newborns through the use of birth weight in combination with DRGs to adjust the u...

Introduction Healthcare systems in the early 1970s, the so called 'golden age' of the welfare state, came much closer to what we characterize as distinct ideal types: the Private Insurance System, the Social Insurance System and the National Health Service (NHS). During the past decades, as a consequence of problem pressure caused, for example, by globalization and demographic change, healthcar...

Prospective payment rates based on Diagnosis Related Groups (DRGs) have been established as the basis of Medicare’s hospital reimbursement system. The DRGs are a patient classification scheme which provides a means of relating the type of patients a hospital treats (i.e., its case mix) to the costs incurred by the hospital. The design and development of the DRGs began in the late sixties at Yal...

There are a number of Diagnosis-Related Group (DRG) classification systems that have evolved over the past 2 decades, each with their own strengths and weaknesses. DRG systems are used for case-mix trending, utilization management and quality improvement, comparative reporting, prospective payment, and price negotiations. For any of these applications it is essential to know the accuracy with w...

This research focuses upon the relationship between a child's age and the likelihood that the child was treated at a Specialist Children's Hospital rather than at a local hospital. While it is generally regarded that younger patients are more resource intensive, a study was required to determine whether the Specialist Children's Hospitals attracted younger patients. The analysis is based on 42,...

In the FY 2011 Inpatient Prospective Payment System (IPPS) Proposed Rule, the Centers for Medicare & Medicaid Services (CMS) described its methodology for measuring the documentation and coding changes the agency believed resulted from the shift to Medicare Severity Diagnosis Related Groups (MS-DRGs). The Moran Company (TMC) was asked to examine CMS' approach and determine if it is an appropria...

The costing of hospital outputs, and especially of acute admitted patients categorised by DRG, has been the focus of considerable attention in the last decade. Many individual hospitals now routinely estimate the costs of their main products, several State and Territory health authorities undertake periodic multi-site studies, and there have been a few one-off national studies. This paper summa...