PMID- 8937944
OWN - NLM
STAT- MEDLINE
DCOM- 19970212
LR  - 20041117
IS  - 0392-0623 (Print)
IS  - 0392-0623 (Linking)
VI  - 28
IP  - 7
DP  - 1996 Sep
TI  - Effect of patient characteristics on hospital costs for cirrhosis: implications 
      for the disease-related group (DRG) reimbursement system.
PG  - 401-5
AB  - The Prospective Payment System uses Diagnosis-Related Groups (DRG) as a 
      reimbursement system. DRG 202 is a disease-related group including liver 
      cirrhosis as a whole. Patients referring to the inpatient unit complain of 
      variable severity and complications of cirrhosis, possibly implying different 
      expenditure of resources. Aim of the investigation was to identify factors 
      affecting cost variability in patients with cirrhosis. A total of 73 consecutive, 
      DRG 202-assigned, cirrhotic patients classified according to demographic and 
      clinical variables were evaluated for length and costs of hospitalization 
      calculated on a full-cost basis. Mean length of hospitalization was 10.2 +/- 7 
      days. Mean cost of hospitalization was Lit. 4.348.000 +/- 2.718.000. Medical, 
      nursing, diagnostic, drug and general charges accounted for 13%, 29%, 37%, 5% and 
      16% of the cost, respectively. Child-Pugh score significantly correlated with 
      drug consumption (p < 0.005), length (p < 0.01) and costs (p < 0.001) of 
      hospitalization, but not with cost per day. Age, sex, admission status, referral 
      reason, associated diseases and liver transplant susceptibility did not correlate 
      with duration and costs of hospitalization. Disease severity significantly 
      modifies costs of hospital admission in cirrhotic patients mostly on account of 
      longer hospital stay. Surrogate indexes of disease severity, derived from 
      ISTAT/DRG records, cannot identify patients consuming larger resources. In liver 
      cirrhosis, the DRG system could be improved by introducing parameters, such as 
      Child-Pugh score, directly taking into account disease severity.
FAU - Rosina, F
AU  - Rosina F
AD  - Dipartimento Sperimentale di Gastroenterologia, Azienda Ospedaliera Le Molinette, 
      Italy.
FAU - Alaria, P
AU  - Alaria P
FAU - Castelli, S
AU  - Castelli S
FAU - Dirindin, N
AU  - Dirindin N
FAU - Rocca, G
AU  - Rocca G
FAU - Actis, G C
AU  - Actis GC
FAU - Borelli, R
AU  - Borelli R
FAU - Ciancio, A L
AU  - Ciancio AL
FAU - De Bernardi, W
AU  - De Bernardi W
FAU - Fornasiero, S
AU  - Fornasiero S
FAU - Lavezzo, B
AU  - Lavezzo B
FAU - Lagget, M
AU  - Lagget M
FAU - Martinotti, R
AU  - Martinotti R
FAU - Marzano, A
AU  - Marzano A
FAU - Ottobrelli, A
AU  - Ottobrelli A
FAU - Sostegni, R
AU  - Sostegni R
FAU - Rizzetto, M
AU  - Rizzetto M
FAU - Verme, G
AU  - Verme G
LA  - eng
PT  - Journal Article
PL  - Italy
TA  - Ital J Gastroenterol
JT  - The Italian journal of gastroenterology
JID - 8000544
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Diagnosis-Related Groups
MH  - Female
MH  - *Hospital Costs
MH  - Humans
MH  - Italy
MH  - Length of Stay/economics
MH  - Liver Cirrhosis/*economics
MH  - Male
MH  - Middle Aged
MH  - *Prospective Payment System
MH  - Severity of Illness Index
EDAT- 1996/09/01 00:00
MHDA- 1996/09/01 00:01
CRDT- 1996/09/01 00:00
PHST- 1996/09/01 00:00 [pubmed]
PHST- 1996/09/01 00:01 [medline]
PHST- 1996/09/01 00:00 [entrez]
PST - ppublish
SO  - Ital J Gastroenterol. 1996 Sep;28(7):401-5.