Patient-reported quality of life before, compared with after a DRG intervention.
OBJECTIVE
To evaluate the effects of the introduction of a payment system based on Diagnosis-Related Groups (DRG) on orthopedic patients' perceptions of quality of life after discharge.


METHODS
A prospective longitudinal study performed between 1992 and 1996.


METHODS
Two surgical clinics in the County of Gävleborg, Sweden.


METHODS
The selection of patients was defined by surgical treatments/diagnoses, and by geographical area. Out of the 40 consecutively recruited patients per year from each hospital, >85% (n = 145 + 140 = 285) completed a questionnaire 1 week post-discharge, and >75% (n = 128 + 127 = 255) did so at a 6-week follow-up.


METHODS
The Swedish Health-Related Quality of Life Survey (SWED-QUAL) was used to assess quality of life. Straight factoral analyses of variance (ANOVAs) were performed to compare years of assessment in the same hospital/district.


RESULTS
The results demonstrated no pattern of significant pre-post differences in patient-reported quality of life. In all years, most quality of life ratings were lower at 1 week compared with 6 weeks after discharge. These differences were probably the consequence of recently undergone surgery.


CONCLUSIONS
The overall conclusion is that changes implemented in health care, including the DRGs, had no demonstrable impact on patient ratings of quality of life.
Ljunggren
Birgitta
B
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. birgitta.ljunggren@hig.se
Sjödén
Per-Olow
PO
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002391:Catchment Area, Health; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000191:economics / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010351:Patient Discharge; D011788:Quality of Life / Q000523:psychology*; D012051:Reimbursement Mechanisms; D018434:Sickness Impact Profile; D013548:Sweden; D013997:Time Factors