Diagnosis-Related Group (DRG)-Based Prospective Hospital Payment System can be well adopted for Acute Care Surgery: Taiwanese Experience with Acute Cholecystitis
نویسندگان
چکیده
BackgroundLaparoscopic cholecystectomy (LC) is a common procedure for cholelithiasis paid by diagnostic-related groups (DRGs) systems. However, acute cholecystitis (AC) patients usually have heterogeneous conditions that compromise the successful implementation of DRGs. We evaluated quality/efficiency treating AC under DRG system in Taiwan.MethodsAll who underwent LC between October 2015 and December 2016 were included. Patient demographics, treatment outcomes, financial results analyzed. Patients reimbursed one two schemes based on their comorbidities/complications (CC): DRG-1, without CC; DRG-2, with CC. Hospitals costs incurred if they below lower threshold (balanced sector); outlier thresholds (profitable plus 80% exceeding cost higher than (profit-losing sector).ResultsAmong 246 patients, 114 132 DRG-2. In total, 195 within 1 day after admission, mild had shorter hospital stays those moderate or severe AC. The complication rate was 7.3% only mortality. 92.1% DRG-1 90.9% DRG-2 profitable. average margin per patient 11,032 TWD 24,993 DRG-2.ConclusionsDRGs can be well adopted care surgery, hospitals still provide satisfactory services losing profit.
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ژورنال
عنوان ژورنال: World Journal of Surgery
سال: 2021
ISSN: ['1432-2323', '0364-2313']
DOI: https://doi.org/10.1007/s00268-020-05904-5