HOW MUCH CHANGE IN THE CASE MIX INDEX IS DRG CREEP

被引：90

作者：

CARTER, GM ^{[1
]}

NEWHOUSE, JP ^{[1
]}

RELLES, DA ^{[1
]}

机构：

[1] HARVARD UNIV,CAMBRIDGE,MA 02138

来源：

JOURNAL OF HEALTH ECONOMICS | 1990年 / 9卷 / 04期

关键词：

D O I：

10.1016/0167-6296(90)90003-L

中图分类号：

F [经济];

学科分类号：

02 ;

摘要：

We re-abstracted a nationally representative sample of 7,887 Medicare charts to determine how much of the change in Medicare's Case Mix Index between 1986 and 1987 was true change in the complexity of cases and how much was upcoding or 'DRG creep'. About two-thirds of the change is true. Most of the remaining third is attributable to a general change in the completeness of coding; some is attributable to changes in the Grouper program. Thus, most of the additional $1 billion paid to hospitals because of the Case Mix Index change appears justified by the additional complexity of patients hospitalized. © 1991.

引用

页码：411 / 428

页数：18

共 6 条

[1]

Carter G., 1990, R3826HCFA RAND CORP

[2]

Ginsburg P B, 1986, Health Care Financ Rev, V7, P51

[3]

*HLTH SYST MAN GRO, 1988, DRG REF DIAGN SPEC C

[4] ACCURACY OF DIAGNOSTIC CODING FOR MEDICARE PATIENTS UNDER THE PROSPECTIVE-PAYMENT SYSTEM [J].