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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.
Scheller-Kreinsen D, Quentin W, on behalf of the EuroDRG
|Verlag||Health Economics 21
(Suppl. 2): 103-115|
- © .
paper assesses the variations in costs and length of stay for hip
replacement cases in Austria, England, Estonia, Finland, France,
Germany, Ireland, Poland, Spain and Sweden and examines the ability of
national diagnosis-related group (DRG) systems to explain the
variation in resource use against a set of patient characteristic and
treatment specific variables. In total, 195 810 cases clustered in 712
hospitals were analyzed using OLS fixed effects models for cost data
(n = 125 698) and negative binominal models for length-of-stay data (n
= 70 112). The number of DRGs differs widely across the 10 European
countries (range: 2–14). Underlying this wide range is a different
use of classification variables, especially secondary diagnoses and
treatment options are considered to a different extent. In six
countries, a standard set of patient characteristics and treatment
variables explain the variation in costs or length of stay better than
the DRG variables. This raises questions about the adequacy of the
countries’ DRG system or the lack of specific criteria, which could
be used as classification variables.
Copyright © 2012 John Wiley & Sons, Ltd.