Reimbursement for intensive care services under diagnosis-related groups

Bekes, C.; Fleming, S.; Scott, Walter E.

doi:10.1097/00003246-198805000-00003

Cited by 24 publications

(4 citation statements)

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“…Indirect measures of resource consumption all have drawbacks. For example, diagnosis may be used but there is a poor relationship between diagnosis and costs [11]. Over 40 diagnostic categories were used in the Intensive Care Society's UK APACHE II study [12] and, even then, five 'catch all' codes were included.…”

Section: Nodementioning

confidence: 99%

Classification treesA possible method for iso‐resource grouping in intensive care

et al. 1998

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Classification and grouping of clinical data into defined categories or hierarchies is difficult in intensive care practice. Diagnosis‐related groups are used to categorise patients on the basis of diagnosis. However, this approach may not be applicable to intensive care where there is wide heterogeneity within diagnostic groups. Classification tree analysis uses selected independent variables to group patients according to a dependent variable in a way that reduces variation. In this study, the influence of three easily identified patient attributes on their length of intensive care unit stay was explored using classification analysis. Two thousand five hundred and forty‐five critically ill patients from three hospitals were classified into groups so that the variation in length of stay within each group was minimised. In 23 out of 39 terminal groups, the interquartile range of the length of stay was ≤ 3 days.

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Section: Nodementioning

confidence: 99%

Classification treesA possible method for iso‐resource grouping in intensive care

et al. 1998

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“…After reviewing 151 of the most severely ill patients admitted to their ICU, Bekes et al (1) observed that the actual expenses per patient were $24,098 higher than the reimbursement that the hospital received based on DRGs. Hughes et al (25) concluded that patients requiring either intubation or mechanical ventilation generated costs that were 2-3 times higher than patients who did not require respiratory assistance, and that these costs were 4-5 times greater in patients in whom a tracheostomy had been performed.…”

Section: Effectivenessmentioning

confidence: 99%

Critically Examining Intensive Care

Miranda¹

1992

Int J Technol Assess Health Care

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The economic recession of the last decade brought intensive care systems under the light of cost-effectiveness analysis, making use of several instruments available in medical practice, and others adapted from for-profit enterprises. The present concept of intensive care, particularly its functional and organizational interactions with traditional specialties, is at the brink of an important revaluation. Studies of the cost-effectiveness of therapeutic actions may be grossly biased if they do not consider the complete process of care (before, during, and after treatment), analyzing even its smallest elements.

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“…With the new era of greater financial accountability, ways are being sought to attribute accurate costs to particular patients so that accurate budgeting and charging out (transfer pricing) to other areas can be achieved. Use of diagnostic related groups (DRGs) for allocating costs to ICU patients has led to underfunding of intensive care in the U.S.A. as they have failed to recognize the complexity of very ill patients [1][2][3][4][5] . Nevertheless attempts are being made in Australia and New Zealand to develop DRGs suitable for application to the ICU.…”

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confidence: 99%

Charging for Intensive Care using Direct Nursing Hours as the Cost Marker

Caspari

McConnell

et al. 1997

Anaesth Intensive Care

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The hypothesis that direct nursing hours correlate with the cost of a patient stay in intensive care was tested. One hundred and thirty-nine patients were studied and the data collected included: (a) direct nursing hours applied to each patient; (b) a daily TISS score: (c) a detailed costing of each patient (all costs are shown in N.Z.$). There was a strong correlation between the direct nursing hours and the total cost per patient (r 2 =0.98) (total cost=54xdirect nursing hours+344). Also a strong correlation existed between the total TISS scores and the total costs per patient (r 2 =0.96) (total cost=67.13xTISS). Direct nursing hours offer a relatively simple and logical method of allocating costs per patient.

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Reimbursement for intensive care services under diagnosis-related groups

Cited by 24 publications

References 0 publications

Classification treesA possible method for iso‐resource grouping in intensive care

Classification treesA possible method for iso‐resource grouping in intensive care

Critically Examining Intensive Care

Charging for Intensive Care using Direct Nursing Hours as the Cost Marker

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