PMID- 34977054
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220104
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 8
DP  - 2021
TI  - A Simple Diagnosis-Related Groups-Based Reimbursement System Is Cost Ineffective 
      for Elderly Patients With Displaced Femoral Neck Fracture Undergoing 
      Hemiarthroplasty in Beijing.
PG  - 733206
LID - 10.3389/fmed.2021.733206 [doi]
LID - 733206
AB  - Displaced femoral neck fractures (FNF) in the elderly are a major public health 
      concern that necessitates hemiarthroplasty (HA) as the mainstay treatment option. 
      Diagnosis-Related Groups (DRG) are a patient classification system that 
      categorizes patients based on the resources expended on them. The first objective 
      of this study was to evaluate if a simplified DRG-based reimbursement system in 
      Beijing would lower total HA treatment costs for elderly patients with displaced 
      FNF. In addition, we aimed to determine how age, gender, year of admission, 
      length of in-hospital stay, and the Charlson index affected total treatment 
      costs. This retrospective study included 513 patients from the Peking Union 
      Medical College Hospital. The patients were diagnosed with unilateral displaced 
      femoral neck fractures and had HA. Medical information was gathered, including 
      baseline demographic and clinical data, as well as treatment costs. Patients were 
      classified into two groups: those who spent more than the predetermined cut-off 
      cost and those who did not. The cost did not include the use of a bipolar 
      prosthesis. Data from the two groups were compared, and multiple regression 
      analysis models were constructed. The median total cost of treatment was  yen49,626 
      ($7,316). The majority of the patients (89.7%; 460/513) were categorized as 
      exceeding the cost cut-off. Multiple linear regression analysis revealed that 
      total treatment cost was positively correlated with age (p < 0.01) and the 
      duration of in-hospital stay (p < 0.01) but not with gender (p = 0.160) or the 
      Charlson index (p = 0.548). On implementing the DRG-based reimbursement system, 
      the overall treatment costs increased by  yen21,028 ($3,099) (p < 0.01). The 
      implementation of simplified DRG-prospective payment systems did not result in a 
      significant reduction in total treatment costs for elderly patients with FNF who 
      underwent HA in Beijing. The overall cost of treatment was associated with 
      several factors, including age, length of hospitalization, and year of admission.
CI  - Copyright (c) 2021 Peng, Xu, Ci, Zhang, Zhang and Weng.
FAU - Peng, Hui-Ming
AU  - Peng HM
AD  - Department of Orthopaedics, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing, China.
FAU - Xu, Yuan
AU  - Xu Y
AD  - Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing, China.
FAU - Ci, Pu-Wo
AU  - Ci PW
AD  - Department of Medical Record, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing, China.
FAU - Zhang, Jia
AU  - Zhang J
AD  - Department of Orthopaedics, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing, China.
FAU - Zhang, Bao-Zhong
AU  - Zhang BZ
AD  - Department of Orthopaedics, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing, China.
FAU - Weng, Xi-Sheng
AU  - Weng XS
AD  - Department of Orthopaedics, Peking Union Medical College Hospital, Chinese 
      Academy of Medical Science, Peking Union Medical College, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20211215
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC8715944
OTO - NOTNLM
OT  - DRG-based reimbursement system
OT  - femoral neck fracture
OT  - hemiarthroplasty
OT  - orthopedics
OT  - surgery
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/01/04 06:00
MHDA- 2022/01/04 06:01
PMCR- 2021/12/15
CRDT- 2022/01/03 05:48
PHST- 2021/06/30 00:00 [received]
PHST- 2021/11/25 00:00 [accepted]
PHST- 2022/01/03 05:48 [entrez]
PHST- 2022/01/04 06:00 [pubmed]
PHST- 2022/01/04 06:01 [medline]
PHST- 2021/12/15 00:00 [pmc-release]
AID - 10.3389/fmed.2021.733206 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2021 Dec 15;8:733206. doi: 10.3389/fmed.2021.733206. 
      eCollection 2021.