Alternative to diagnosis-related groups for newborn intensive care.
Clinical and billing data were collected on all admissions to six California newborn intensive care units during a 6-month period. Charges were adjusted to costs using Medicaid cost to charge ratios and for inflation, and patients were classified by the diagnosis-related group (DRG) system. Costs were from 97% to 708% more than the proposed DRG reimbursement levels. Regression analysis showed that DRGs explained 22% of the variation in costs. An alternative model using binary variables to control for birth weight, assisted ventilation, surgery, survival, multiple births, and mode of discharge explained 42% of the variation in costs. In contrast to other proposed DRG alternatives, this simple model does not require special training or subjective decision-making.
D001724:Birth Weight; D003422:Critical Care / Q000191:economics*; D003953:Diagnosis-Related Groups / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000191:economics; D012044:Regression Analysis; D012121:Respiration, Artificial; D014481:United States