Ann Surg Treat Res.  2014 Sep;87(3):148-155. 10.4174/astr.2014.87.3.148.

Evaluating the efficacy of the current diagnosis-related group reimbursement system for laparoscopic appendectomy at a single institute in Korea

• Yoo RN
• Chung CW
• Kim JW

• KMID: 1908486
• DOI: http://doi.org/10.4174/astr.2014.87.3.148

Abstract

PURPOSE
The diagnosis-related group (DRG) system has been adapted to reduce overall medical costs by grouping and classifying relatively homogenous patients based on similar resource consumption patterns in the treatment. However, despite its wide range of disease manifestation from early inflammation to severe peritonitis, acute appendicitis is included in the DRG system. Responding to a need to assess the DRG system for patients diagnosed with appendicitis, this study evaluates the efficacy of the current DRG system applied to a broad spectrum of the patients with appendicitis undergoing laparoscopic appendectomy.
METHODS
A retrospective review was conducted of the patients who underwent laparoscopic appendectomy. Based on the DRG codes' classification, the patients were analyzed for the amount of DRG reimbursement and the total in-patient cost in relation to the time sequence of the disease onset. Statistical analysis was performed to find factors correlated with the DRG reimbursement and total in-patient cost.
RESULTS
Findings indicate that, as the symptom duration becomes prolonged, the CRP level and the use of peritoneal drainage increased. Patients with a symptom duration greater than 24 hours required approximately 5 days of hospital stay, 0.5 day longer in the length of hospital stay than that of patients with less than 12 hours of the onset time. As expected, the amount of DRG reimbursement and the total in-patient cost accumulated as the symptom duration increased.
CONCLUSION
The current DRG reimbursement system for the patients undergoing laparoscopic appendectomy recompenses a broad spectrum of patients diagnosed with appendicitis effectively.

Keyword

Diagnosis-related groups; Laparoscopy; Appendectomy; Severity of illness index

MeSH Terms

Appendectomy*
Appendicitis
Classification
Diagnosis-Related Groups*
Drainage
Humans
Inflammation
Korea
Laparoscopy
Length of Stay
Peritonitis
Retrospective Studies
Severity of Illness Index

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