title: Financial risk and hospital cost for elderly patients in non-age stratified urology DRGs.
abstract: The Diagnostic Related Group (DRG) hospital payment system may be inequitable for certain groups of Medicare patients. This study of 216 Medicare urology patients in the ten non-age stratified urology DRGs demonstrated that patients seventy years of age and older (70+) had higher resource consumption than patients under seventy years of age (70-). Findings were: (1) older patients (70+) had higher total hospital costs (+12,022 per patient) than younger patients (70-) (+9,872 per patient); (2) a longer hospital length of stay (14.2 days vs 11.6 days); (3) financial risk of +1,756 loss per (70+) patient vs +1,309 profit per (70-) patient (p less than 0.05); (4) more diagnoses and procedures per patient, and (5) a higher mortality (4.0% vs 3.3%). These findings suggest that the current DRG scheme may be inequitable vis-a-vis the older urology patient in non-age stratified DRGs, and thus could limit access and quality of care for these patients in the future.
authors.affiliation: Department of Surgery, Queens Hospital Center, Jamaica, New York.
authors.forename: E
authors.initials: E
authors.lastname: Muñoz
authors.forename: S
authors.initials: S
authors.lastname: Wilkins
authors.forename: E
authors.initials: E
authors.lastname: Mallet
authors.forename: J
authors.initials: J
authors.lastname: Goldstein
authors.forename: H
authors.initials: H
authors.lastname: Sterman
authors.forename: L
authors.initials: L
authors.lastname: Wise
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups; D006746:Hospital Bed Capacity, 500 and over; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D006278:Medicare / Q000191:economics*; D009519:New York City; D012307:Risk Factors; D014481:United States; D014570:Urologic Diseases / Q000145:classification / Q000191:economics*