title: Diagnosis related groups and variations in resource use for child delivery across 10 European countries.
abstract: Childbirth is one of the main causes of hospitalisation for women, accounting for about 5% of hospital activity in most Organisation for Economic Co-operation and Development countries. We analysed the factors that explain variations in resource use for child delivery in ten European countries. We compared the performance of three models for explaining the variations in resource use (log cost or length of inpatient stay) at patient and hospital level. The first model used only the DRGs to which child deliveries were coded (M(D) ), the second used a set of 'patient-level' and delivery specific explanatory variables (M(P) ), and the third model combined both sets of variables (M(F) ). Countries vary both in the number of DRGs and the criteria used to classify cases of child delivery (range: 3-8) and in the percentage of deliveries classified as 'delivery without complication' (range: 53-90%). The capacity of DRGs and patient level variables to explain cost variation for child birth ranges from 48% in Sweden to over 70% in Spain. There is room for improving current DRG classification in most countries, but this does not necessary imply multiplying the groups and/or complicating criteria. Countries with a higher number of DRGs do not always perform better.
authors: Institut de recherche et documentation en économie de la santé, Paris, France. or@irdes.fr
authors: Zeynep
authors: Z
authors: Or
authors: Thomas
authors: T
authors: Renaud
authors: Josselin
authors: J
authors: Thuilliez
authors: Cora
authors: C
authors: Lebreton
mesh_terms: D000367:Age Factors; D036861:Delivery, Obstetric / Q000191:economics* / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D018803:Models, Economic; D012044:Regression Analysis