DIAGNOSIS RELATED GROUPS AND VARIATIONS IN RESOURCE USE FOR CHILD DELIVERY ACROSS 10 EUROPEAN COUNTRIES
分析了十个欧洲国家中分娩资源使用差异的影响因素，比较了仅用DRG、仅用患者特征变量及两者结合三种模型解释成本或住院天数的能力，发现各国DRG分类数量和效果差异大，增加分组数不一定提升解释力。
Childbirth is one of the main causes of hospitalisation for women, accounting for about 5% of hospital activity in most Organisation for Economic Co-operation and Development countries. We analysed the factors that explain variations in resource use for child delivery in ten European countries. We compared the performance of three models for explaining the variations in resource use (log cost or length of inpatient stay) at patient and hospital level. The first model used only the DRGs to which child deliveries were coded (M(D) ), the second used a set of 'patient-level' and delivery specific explanatory variables (M(P) ), and the third model combined both sets of variables (M(F) ). Countries vary both in the number of DRGs and the criteria used to classify cases of child delivery (range: 3-8) and in the percentage of deliveries classified as 'delivery without complication' (range: 53-90%). The capacity of DRGs and patient level variables to explain cost variation for child birth ranges from 48% in Sweden to over 70% in Spain. There is room for improving current DRG classification in most countries, but this does not necessary imply multiplying the groups and/or complicating criteria. Countries with a higher number of DRGs do not always perform better.