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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|
- © .
This 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.