The Effect of Diagnosis-Related Group Payment System on Quality of Care in the Field of Obstetrics and Gynecology among Korean Tertiary Hospitals

Yonsei Medical Journal
Yong Wook JungEui Hyeok Kim

Abstract

To examine changes in clinical practice patterns following the introduction of diagnosis-related groups (DRGs) under the fee-for-service payment system in July 2013 among Korean tertiary hospitals and to evaluate its effect on the quality of hospital care. Using the 2012-2014 administrative database from National Health Insurance Service claim data, we reviewed medical information for 160400 patients who underwent cesarean sections (C-secs), hysterectomies, or adnexectomies at 43 tertiary hospitals. We compared changes in several variables, including length of stay, spillover, readmission rate, and the number of simultaneous and emergency operations, from before to after introduction of the DRGs. DRGs significantly reduced the length of stay of patients undergoing C-secs, hysterectomies, and adnexectomies (8.0±6.9 vs. 6.0±2.3 days, 7.4±3.5 vs. 6.4±2.7 days, 6.3±3.6 vs. 6.2±4.0 days, respectively, all p<0.001). Readmission rates decreased after introduction of DRGs (2.13% vs. 1.19% for C-secs, 4.51% vs. 3.05% for hysterectomies, 4.77% vs. 2.65% for adnexectomies, all p<0.001). Spillover rates did not change. Simultaneous surgeries, such as colpopexy and transobturator-tape procedures, during hysterectomies decreased, while colpo...Continue Reading

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Nov 26, 2016·The Journal of Surgical Research·Tae Hyun KimJae Woo Choi

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Citations

Apr 21, 2021·Scientific Reports·Soo Jin ParkUNKNOWN PRAHA Study Group
May 7, 2021·Health Policy and Planning·Emma GhazaryanKrishna D Rao
May 19, 2021·Health Economics Review·Gintare ValentelyteJan Sorensen

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Methods Mentioned

BETA
cesarean sections
hysterectomy
hysterectomies

Software Mentioned

SAS

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