Diagnosis-related group regulations. Implications for the practicing rheumatologist.
Data from our university hospital on the 2 most common rheumatologic diseases that require hospitalization indicate that total charges for patients admitted with rheumatoid arthritis or systemic lupus erythematosus break down as follows: room, board, and nursing, 55%; tests/procedures, 30%; drugs, 5%; physical and occupational therapy, 5%; and miscellaneous, 5%. Thus, shortening the length of stay would be the most effective mechanism to reduce total charges. We also found marked heterogeneity in the single diagnosis-related group containing rheumatoid arthritis and systemic lupus erythematosus inpatients under 70 years old who had no comorbid conditions. Planners should be sensitive to this as prospective reimbursement is extended beyond Medicare patients.
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000191:economics* / Q000534:rehabilitation; D003365:Costs and Cost Analysis / Q000191:economics*; D003953:Diagnosis-Related Groups / Q000191:economics*; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D008180:Lupus Erythematosus, Systemic / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000191:economics; D026741:Physical Therapy Modalities / Q000191:economics; D014481:United States