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English Abstract
- Impact of DRG Payment on the Length of Stay and the Number of Outpatient Visits After Discharge for Caesarean Section During 2004-2007.
- Changwoo Shon, Seolhee Chung, Seonju Yi, Soonman Kwon
- J Prev Med Public Health. 2011;44(1):48-55.
- DOI: https://doi.org/10.3961/jpmph.2011.44.1.48
- 7,020 View
- 163 Download
- 9 Crossref
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Abstract
PDF - OBJECTIVES
The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. METHODS: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. RESULTS: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. CONCLUSIONS: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program. -
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Citations
Citations to this article as recorded by
- The effects of DRGs-based payment compared with cost-based payment on inpatient healthcare utilization: A systematic review and meta-analysis
Zhaolin Meng, Wen Hui, Yuanyi Cai, Jiazhou Liu, Huazhang Wu
Health Policy.2020; 124(4): 359. CrossRef - Effects of a mandatory DRG payment system in South Korea: Analysis of multi-year nationwide hospital claims data
Jae Woo Choi, Seung-Ju Kim, Hye-Ki Park, Sung-In Jang, Tae Hyun Kim, Eun-Cheol Park
BMC Health Services Research.2019;[Epub] CrossRef - Early Impact on Outpatients of Mandatory Adoption of the Diagnosis‐Related Group‐Based Reimbursement System in Korea on Use of Outpatient Care: Differences in Medical Utilization and Presurgery Examination
Seung Ju Kim, Kyu‐Tae Han, Woorim Kim, Sun Jung Kim, Eun‐Cheol Park
Health Services Research.2018; 53(4): 2064. CrossRef - The effect of competition on the relationship between the introduction of the DRG system and quality of care in Korea
Seung Ju Kim, Eun-Cheol Park, Sun Jung Kim, Kyu-Tae Han, Euna Han, Sung-In Jang, Tae Hyun Kim
The European Journal of Public Health.2016; 26(1): 42. CrossRef - Impact of payment system change from per-case to per-diem on high severity patient's length of stay
Sung-In Jang, Chung Mo Nam, Sang Gyu Lee, Tae Hyun Kim, Sohee Park, Eun-Cheol Park
Medicine.2016; 95(37): e4839. CrossRef - The Effect of Mandatory Diagnosis-Related Groups Payment System
Jae-Woo Choi, Sung-In Jang, Suk-Yong Jang, Seung-Ju Kim, Hye-Ki Park, Tae Hyun Kim, Eun-Cheol Park
Health Policy and Management.2016; 26(2): 135. CrossRef - Is the Hospital Caseload of Diagnosis Related Groups Related to Medical Charges and Length of Stay?
Jin-Mi Kwak, Kwang-Soo Lee
The Korean Journal of Health Service Management.2014; 8(4): 13. CrossRef - Perspectives on cost containment and quality of health care in the DRG payment system of Korea
Jaewook Choi
Journal of the Korean Medical Association.2012; 55(8): 706. CrossRef - Nurses' Cognition of Diagnosis Related Group (DRG) in Long-term Care Hospitals and Changes in Nursing Care after Application of DRG
Eun Ha, Kyeha Kim
Journal of Korean Academy of Nursing Administration.2012; 18(2): 176. CrossRef
Original Article- Impacts of DRG Payment System on Behavior of Medical Insurance Claimants.
- Beom Man Ha, Gilwon Kang, Hyoung Keun Park, Chang Yup Kim, Yong Ik Kim
- Korean J Prev Med. 2000;33(4):393-401.
- 3,013 View
- 32 Download
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Abstract
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- OBJECTIVES
To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. METHODS: In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. RESULTS: The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.9% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). CONCLUSIONS: After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed. -
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