Hospital costs, cancer patients, and surgical diagnostic related groups

Journal of Surgical Oncology
E MuñozL Wise

Abstract

This study of 4,359 Medicare patients in 107 noncancer stratified surgical Diagnostic Related Groups (DRGs) tested the hypothesis that patients with a diagnosis of a malignancy (i.e., cancer) in these DRGs would have higher resource utilization than patients without a diagnosis of a malignancy (i.e., noncancer) in these same surgical DRGs. The 1,008 cancer patients had 3.2 times the financial loss ($1,617 per patient vs. $510 per patient) compared to the 3,351 noncancer patients (P less than .05). Patients with cancer had a greater percentage of outliers, more diagnosis (P less than .0001) and procedures (P less than .0001) per patient, and a higher mortality (P less than .01) than patients without cancer. These findings raise the question of the equity of DRG payment for patients with cancer in many surgical DRGs. Financial disincentives to treat certain groups of Medicare cancer patients at our hospital may affect both their access and quality of care in the future.

References

Jun 1, 1986·American Journal of Public Health·E MuñozL Wise
Jul 10, 1987·JAMA : the Journal of the American Medical Association·J F FitzgeraldR S Dittus
Oct 4, 1985·JAMA : the Journal of the American Medical Association·E MuñozL Wise
Nov 15, 1984·The New England Journal of Medicine·G S Omenn, D A Conrad

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Citations

Jul 6, 2000·Journal of Clinical Epidemiology·J L FreemanJ S Goodwin
Jan 1, 1993·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·G J BonselC A Uyl-de Groot

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