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How well do diagnosis-related group systems group breast cancer surgery patients? - Evidence from 10 european countries.
D, on behalf of the EuroDRG
|Verlag||Health Economics 21
(Suppl. 2): 41-54|
- © .
We analysed patient-level data (n = 72 235) from
563 hospitals in 10 European countries to assess the ability of
national diagnosis-related group (DRG) systems to account for
patient-level variation in cost or lengths of stay of breast cancer
surgery patients against a standard set of patient characteristics,
treatment and quality variables. We find that European DRG systems use
very different types of classification variables and numbers of DRGs
(range: 3–7) to classify these patients. In 6 of 10 countries, the
set of patient characteristics, treatment and quality variables, which
we were able to define across countries, perform better than the set
of national DRGs in accounting for patient-level variation in resource
consumption. Moreover, there appear to be factors that are
consistently significant determinants of cost/length of stay of breast
cancer surgery cases but are not, or at least not fully, considered in
European DRG systems. Our results therefore raise concerns as to
whether all systems rely on the most appropriate classification
variables. In several countries, policymakers should reevaluate the
appropriateness of their DRG algorithm for breast cancer surgery and
of specific DRG weights. Copyright
© 2012 John Wiley & Sons, Ltd.