Ann Surg Treat Res.  2015 Mar;88(3):126-132. 10.4174/astr.2015.88.3.126.

Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy

• Kim H
• Jung IM
• Yun KW
• Heo SC
• Ahn YJ
• Hwang KT
• Lee HW
• Koo DH
• Ko E
• Ahn HS
• Shin R
• Chung JK

• KMID: 2266869
• DOI: http://doi.org/10.4174/astr.2015.88.3.126

Abstract

PURPOSE
The implementation of the Korean diagnosis-related groups (DRG) payment system has been recently introduced in selected several diseases including appendectomy in Korea. Here, we report the early outcomes with regard to clinical aspects and medical costs of the Korean DRG system for appendectomies in Seoul Metropolitan Government - Seoul National University Boramae Medical Center throughout comparing before and after introduction of DRG system.
METHODS
The DRG system was applied since January 2013 at our institute. After the DRG system, we strategically designed and applied our algorithm for the treatment of probable appendicitis. We reviewed the patients who were treated with a procedure of appendectomy for probable appendicitis between July 2012 and June 2013, divided two groups based on before and after the application of DRG system, and compared clinical outcomes and medical costs.
RESULTS
Total 416 patients were included (204 patients vs. 212 patients in the group before vs. after DRG). Shorter hospital stays (2.98 +/- 1.77 days vs. 3.82 +/- 1.84 days, P < 0.001) were found in the group after DRG. Otherwise, there were no significant differences in the perioperative outcomes and medical costs including costs for first hospitalization and operation, costs for follow-up after discharge, frequency of visits of out-patient's clinic or Emergency Department or rehospitalization.
CONCLUSION
In the Korean DRG system for appendectomy, there were no significant differences in perioperative outcomes and medical costs, except shorter hospital stay. Further studies should be continued to evaluate the current Korean DRG system for appendectomy and further modifications and supplementations are needed in the future.

Keyword

Appendicitis; Diagnosis-related groups; Health care costs; Prospective payment system

MeSH Terms

Appendectomy*
Appendicitis
Diagnosis-Related Groups*
Emergency Service, Hospital
Follow-Up Studies
Health Care Costs
Hospitalization
Humans
Korea
Length of Stay
Local Government
Prospective Payment System
Seoul

Figure

• 

  Fig. 1 Algorithm for the treatment of probable appendicitis. PCD, percutaneous catheter drainage.

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