title: Hospital costs, cancer patients, and gynecology diagnostic related groups.
abstract: This study of 115 Medicare gynecology patients in five noncancer-designated gynecology diagnostic related groups (DRGs) demonstrated that patients with a diagnosis of a malignancy (N = 52) had significantly higher hospital resource utilization compared to patients without a malignancy (N = 63) in these gynecology DRGs. Cancer patients had higher total hospital costs (P less than 0.001), longer hospital length of stay (P less than 0.01), significant financial losses under DRGs (P less than 0.01), greater percentage of outliers (P less than 0.05), greater severity of illness, and greater mortality (P less than 0.001) compared to noncancer patients in these same gynecology DRGs. These findings raise the question of whether hospitals will be adequately reimbursed by DRGs for many gynecology cancer patients. Disincentives for hospitals to treat gynecology cancer patients under the current DRG reimbursement system may affect both the access to and the quality of care.
authors.affiliation: Department of Obstetrics-Gynecology, Queens Hospital Center, Jamaica, New York 11432.
authors.forename: E
authors.initials: E
authors.lastname: Muñoz
authors.forename: V
authors.initials: V
authors.lastname: Seltzer
authors.forename: H
authors.initials: H
authors.lastname: Sterman
authors.forename: J R
authors.initials: JR
authors.lastname: Cohen
authors.forename: J
authors.initials: J
authors.lastname: Goldstein
authors.forename: L
authors.initials: L
authors.lastname: Wise
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D005260:Female; D005831:Genital Diseases, Female / Q000191:economics*; D005833:Genital Neoplasms, Female / Q000191:economics*; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D006278:Medicare / Q000191:economics; D009518:New York; D012052:Reimbursement, Incentive; D012720:Severity of Illness Index; D014481:United States