title: Patient classification and hospital costs of care for acute myocardial infarction in nine European countries.
abstract: This study contributes to the literature on the performance of diagnosis-related groups (DRGs) for acute myocardial infarction (AMI) patients by evaluating in nine countries the factors--in addition to DRGs--that affect costs or length of stay and comparing the variation that can be explained with or without DRGs. We evaluate whether the existing DRGs for AMI patients would benefit from additional patient-related and treatment-related factors that are found in administrative data across countries. In most countries, the set of patient and quality variables performed better than the DRG variables. Our results suggest that DRG systems in all countries could be improved by including additional explanatory factors or by refining the existing DRGs. Our results suggest that for AMI and possibly for other related episodes, a refinement of DRGs to include information on patient severity, procedures and levels of complications could improve the ability of DRGs to explain resource use. It seems possible to improve DRG-like hospital payment systems through the inclusion of episode-specific variables.
authors: Centre for Health and Social Economics, National Institute for Health and Welfare, Helsinki, Finland. unto.hakkinen@thl.fi
authors: Unto
authors: U
authors: Häkkinen
authors: Pietro
authors: P
authors: Chiarello
authors: Francesc
authors: F
authors: Cots
authors: Mikko
authors: M
authors: Peltola
authors: Hanna
authors: H
authors: Rättö
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017225:Atherectomy, Coronary / Q000191:economics; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009203:Myocardial Infarction / Q000150:complications / Q000191:economics* / Q000453:epidemiology / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000191:economics; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012737:Sex Factors; D015607:Stents