PATIENT CLASSIFICATION AND HOSPITAL COSTS OF CARE FOR ACUTE MYOCARDIAL INFARCTION IN NINE EUROPEAN COUNTRIES
研究评估了九个欧洲国家中，除诊断相关分组外影响急性心肌梗死患者住院成本和住院时间的因素，发现加入患者严重程度、治疗过程和并发症等变量能改进现有分组系统对资源消耗的解释力。
This study contributes to the literature on the performance of diagnosis-related groups (DRGs) for acute myocardial infarction (AMI) patients by evaluating in nine countries the factors--in addition to DRGs--that affect costs or length of stay and comparing the variation that can be explained with or without DRGs. We evaluate whether the existing DRGs for AMI patients would benefit from additional patient-related and treatment-related factors that are found in administrative data across countries. In most countries, the set of patient and quality variables performed better than the DRG variables. Our results suggest that DRG systems in all countries could be improved by including additional explanatory factors or by refining the existing DRGs. Our results suggest that for AMI and possibly for other related episodes, a refinement of DRGs to include information on patient severity, procedures and levels of complications could improve the ability of DRGs to explain resource use. It seems possible to improve DRG-like hospital payment systems through the inclusion of episode-specific variables.