Using diagnosis-related groups for studying variations in hospital admissions

The diagnosis-related groups (DRG's) have classically focused on resources consumed during a hospital stay. DRG's can also be considered categories for describing cases admitted to a hospital. In this article, we illustrate how consistent patterns of variations in admission rates can be used to classify DRG categories according to the Index of Discretionary Admissions. The consistency of variation in admission rates for modified DRG categories across hospital service areas in Iowa, California, Massachusetts, and Maine was high. The proportion of hospital admissions in the DRG's judged to be most discretionary ranged from 22 percent in Iowa to 14 percent in California.

[1]  J. Freeman,et al.  ARE HOSPITAL SERVICES RATIONED IN NEW HAVEN OR OVER-UTILISED IN BOSTON? , 1987, The Lancet.

[2]  J. Wennberg,et al.  Population illness rates do not explain population hospitalization rates. A comment on Mark Blumberg's thesis that morbidity adjusters are needed to interpret small area variations. , 1987, Medical care.

[3]  K. McPherson,et al.  Will payment based on diagnosis-related groups control hospital costs? , 1984, The New England journal of medicine.

[4]  P. Clifford,et al.  Small-area variations in the use of common surgical procedures: an international comparison of New England, England, and Norway. , 1982, The New England journal of medicine.

[5]  N. Roos,et al.  Surgical Rate Variations: Do They Reflect the Health or Socioeconomic Characteristics of the Population? , 1982, Medical care.

[6]  A. Gittelsohn,et al.  Variations in medical care among small areas. , 1982, Scientific American.

[7]  K. McPherson,et al.  Regional variations in the use of common surgical procedures: within and between England and Wales, Canada and the United States of America. , 1981, Social science & medicine. Part A, Medical sociology.

[8]  R. Fetter,et al.  Case mix definition by diagnosis-related groups. , 1980, Medical care.

[9]  Mary Chatfield,et al.  Health Care Financing Review , 1980 .

[10]  William F. Mitty,et al.  Costs, Risks, and Benefits of Surgery , 1978 .

[11]  F. Dyck,et al.  Effect of surveillance on the number of hysterectomies in the province of Saskatchewan. , 1977, The New England journal of medicine.

[12]  A. Gittelsohn,et al.  Changes in tonsillectomy rates associated with feedback and review. , 1977, Pediatrics.

[13]  A. Ulene,et al.  Hysterectomy or tubal ligation for sterilization: a cost-effectiveness analysis. , 1977, Inquiry : a journal of medical care organization, provision and financing.

[14]  J. Paradise,et al.  Toward rational indications for tonsil and adenoid surgery. , 1976, Hospital practice.

[15]  R. Bolande Ritualistic surgery--circumcision and tonsillectomy. , 1969, The New England journal of medicine.

[16]  W. Deamer PREVENTIVE PEDIATRICS: Child Health and Development , 1963 .

[17]  N. Roos,et al.  Variations in physicians' hospitalization practices: a population-based study in Manitoba, Canada. , 1986, American journal of public health.

[18]  D. Reboussin,et al.  Use of medical care in the Rand Health Insurance Experiment. Diagnosis- and service-specific analyses in a randomized controlled trial. , 1986, Medical care.

[19]  J. Knickman,et al.  A statistical analysis of reasons for East-West differences in hospital use. , 1985, Inquiry : a journal of medical care organization, provision and financing.

[20]  B. Barnes,et al.  Professional uncertainty and the problem of supplier-induced demand. , 1982, Social science & medicine.

[21]  J. Berlin,et al.  Elective hysterectomy. , 1977, American journal of obstetrics and gynecology.

[22]  F. Mosteller,et al.  Costs, Risks, and Benefits of Surgery , 1977 .