The debate over Diagnosis Related Groups
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With the advent of the Prospective Payment System (PPS) using Diagnosis Related Groups (DRGs) as a classification method, the pros and cons of that mechanism have been sharply debated. Grouping the comments into categories related to administration/management, DRG system and quality of care, a review of relevant literature highlights the pertinent attitudes and views of professionals and organizations. Points constantly argued include data utilization, meaningful medical classifications, resource use, gaming, profit centers, patient homogenieity, severity of illness, length of stay, technology limitations and the erosion of standards.
- Federal Register.Medicare Program: Prospective Payment for Medicare Inpatient Hospital Services: Final Rule. Part VI, January 3, 1984, p. 235.
- Meyer, JA (1984) Increased Consumer Cost-Conscious and Competition. Bulletin of the New York Academy of Medicine 60: pp. 98-105
- Wallace, AG, Ellenbogen, PS (1984) DRGs: A Positive Side of the Ledger. North Carolina Medical Journal 45: pp. 232-233
- Neuhauser, D (1983) A Message to Physicians. The Internist 24: pp. 23-25
- Kaemmerer, C (1983) A New Reimbursement System. DRGs Are Coming. Connecticut Medicine 47: pp. 677-679
- Rajani, K, Dally, AD (1983) Medicare DRGs: Facts and Fallacies. Wisconsin Medical Journal 82: pp. 11-13
- Yasko, JM, Fleck, A (1984) Prospective Payment (DRGs): What Will Be the Impact on Cancer Care?. Oncology Nursing Forum 33: pp. 63-72
- Bird, S, Mailhot, C (1983) DRGs: A New Way to Reimburse Hospital Costs. AORN Journal 38: pp. 773-777
- Beth Israel Hospital, Newark, N.J. Outline notes for address on DRGs. Undated.
- Powers, DK (1982) Presentation to Subcommittee on Health and the Environment. House Energy and Commerce Committee, Washington, D.C.
- Bradley D: Per-Case Prospective Payment Under the DRG Methodology. A Three Year Experience in New Jersey. Morristown Memorial Hospital, Morristown, N.J. Undated.
- Riddick, FA (1983) The Doctor and the DRG. The Internist 24: pp. 17-18
- Hospital Peer Review. Officials Spot Inequities in DRG Cost Control Program.6(2):13–15, 1981.
- Health Research and Educational Trust of New Jersey.DRG Evaluation. Volume III Case-Mix Classification, Data, and Management. Princeton, N.J., February 1984, p. 22.
- Richards, JF (1983) Prospective Reimbursement and DRGs. Journal of the Florida Medical Association 70: pp. 363-366
- Bentley, JD, Butler, PW (1981) The DRG Case Mix of a Sample of Teaching Hospitals: A Technical Report. Association of American Medical Colleges, Washington, D.C.
- Henry, L (1980) Hospital Concern Shown With New Pay Method Based on Case-Mix, Diagnosis Related Groups. Hospitals 54: pp. 22-24
- New Jersey Hospital Association.The DRG Maze. Unravelling the Mysteries of Hospital Reimbursement in New Jersey. Princeton, N.J., 1980.
- Friedman, E (1983) Getting to Know Us. Hospitals May Finally Learn the True Cost and Pricing. Hospitals 57: pp. 74
- Keith, SN (1983) Prospective Payment for Hospital Costs Using Diagnosis Related Groups: Will Cost Inflation Be Reduced?. Journal of the National Medical Association 75: pp. 609-622
- Grimaldi, PL (1981) Can State Rate Review Programs Curb Costs Without Harming Quality?. Hospital Progress 60: pp. 6
- Levey, GS (1983) Government Revamp of the Health Care System: Effect on Patient Care and Research. The Pharos 46: pp. 23-27
- Williams, SV, Kominski, GF, Dowd, BE, Soper, KA (1984) Methodological Limitations in Case Mix Hospital Reimbursement, With a Proposal for Change. Inquiry 21: pp. 17-31
- American Medical News. DRG Programs Should Be Approached Cautiously. Cautiously. (Editorial).26(24):4 (June 24), 1983.
- Fuchs, VR (1974) Who Shall Live? Health, Economics, and Social Choice. Basic Books, Inc., N.Y.
- Doremus, HD (1980) DRGs May Be Raising False Expectations. Hospitals 54: pp. 47-51
- Healthcare Financial Management Association. Analysis of Department of Health and Human Services Prospective Payment Proposal. Washington, D.C., January 14, 1983.
- Burick, D, Nackel, J (1981) Diagnosis Related Groups: Tool for Management. Hospital & Health Services Administration 26: pp. 25-40
- Ernst, Whinney:The Revised DRGs. Their Importance in Medicare Payments to Hospitals. E&W No. J58442. May 1983, p. 3.
- Johnson, AN, Appel, GL (1983) Hospitals Will Fight Biased DRG System. Modern Healthcare 13: pp. 192-194
- Hughes, GS (1984) Diagnosis-Related Groups (letter). Annals of Internal Medicine 101: pp. 138
- Alper, PR (1984) Moderating Hospital Costs. Medical World News 25: pp. 76
- McIllrath, S (1984) Revised Grace Panel Report: No DRGs for Physician. American Medical News 27: pp. 1
- American Medical News. DRGs Raise Questions for Medicine, Council Says.26(18):32 (May 13), 1983.
- The debate over Diagnosis Related Groups
Journal of Community Health
Volume 10, Issue 2 , pp 81-92
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