Original Article : The impacts of DRG payment system on financial balance of multiple trauma: Experiences of three trauma centers in Taiwan
Copyright © 2023 Elsevier Ltd. All rights reserved..
INTRODUCTION: There are concerns regarding the adequacy of applying the diagnosis-related groups (DRG) payment system for multiple traumas (i.e., major diagnostic category 24, MDC-24) patients in Taiwan. Therefore, this study used a multi-center dataset to assess the influence of the DRG payment system on the cost and outcome of multiple trauma care.
MATERIALS AND METHODS: We collected data of all multiple trauma patients from the Trauma Registry of three hospitals from 2014 - 2017. Next, we selected patients who met the criteria of MDC-24 and calculated the corresponding DRG payment. Subsequently, we combined the clinical care information with health insurance information to analyze the problems of applying the DRG payment system to multiple trauma care.
RESULTS: Overall, of 465 cases, 367 met the criteria of MDC-24, and the mean injury severity score (ISS) was high (average 20.1). The total deficit of the polytrauma DRG cases amounted to 131,445 USD, and the average deficit in each case was 397 USD. In the multivariable analysis, higher revised trauma score and specific lower abbreviated Injury Scale (AIS) scores in certain body regions resulted in profits, while increased length of stay in intensive care units, longer operative time, and higher AIS score in the thorax were significantly correlated with deficits in medical costs.
CONCLUSION: Our study revealed that the current DRG payment system results in financial losses for hospitals. Further, the payment grouping of MDC-24 should consider adding more disease severity factors to reduce the financial constraints faced by trauma centers.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
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| Enthalten in: |
Injury - 54(2023), 9 vom: 10. Sept., Seite 110703 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wu, Chao-Ying [VerfasserIn] |
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| Links: |
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| Themen: |
Diagnosis-related groups |
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| Anmerkungen: |
Date Completed 14.08.2023 Date Revised 14.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.injury.2023.03.031 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM35550023X |
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| 100 | 1 | |a Wu, Chao-Ying |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Original Article |b The impacts of DRG payment system on financial balance of multiple trauma: Experiences of three trauma centers in Taiwan |
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| 500 | |a Date Completed 14.08.2023 | ||
| 500 | |a Date Revised 14.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Ltd. All rights reserved. | ||
| 520 | |a INTRODUCTION: There are concerns regarding the adequacy of applying the diagnosis-related groups (DRG) payment system for multiple traumas (i.e., major diagnostic category 24, MDC-24) patients in Taiwan. Therefore, this study used a multi-center dataset to assess the influence of the DRG payment system on the cost and outcome of multiple trauma care | ||
| 520 | |a MATERIALS AND METHODS: We collected data of all multiple trauma patients from the Trauma Registry of three hospitals from 2014 - 2017. Next, we selected patients who met the criteria of MDC-24 and calculated the corresponding DRG payment. Subsequently, we combined the clinical care information with health insurance information to analyze the problems of applying the DRG payment system to multiple trauma care | ||
| 520 | |a RESULTS: Overall, of 465 cases, 367 met the criteria of MDC-24, and the mean injury severity score (ISS) was high (average 20.1). The total deficit of the polytrauma DRG cases amounted to 131,445 USD, and the average deficit in each case was 397 USD. In the multivariable analysis, higher revised trauma score and specific lower abbreviated Injury Scale (AIS) scores in certain body regions resulted in profits, while increased length of stay in intensive care units, longer operative time, and higher AIS score in the thorax were significantly correlated with deficits in medical costs | ||
| 520 | |a CONCLUSION: Our study revealed that the current DRG payment system results in financial losses for hospitals. Further, the payment grouping of MDC-24 should consider adding more disease severity factors to reduce the financial constraints faced by trauma centers | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diagnosis-related groups | |
| 650 | 4 | |a Injury severity score | |
| 650 | 4 | |a Multiple trauma | |
| 650 | 4 | |a Revised trauma score | |
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| 700 | 1 | |a Lin, Chen-Chiang |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Huei-Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Rey-Heng |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Ching-Lin |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Tzu-Hsin |e verfasserin |4 aut | |
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