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Patient Classification And Hospital Costs Of Care For Acute Myocardial Infarction In Nine European Countries

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  • Unto Häkkinen
  • Pietro Chiarello
  • Francesc Cots
  • Mikko Peltola
  • Hanna Rättö
  • ON BEHALF OF THE EURODRG GROUP

Abstract

This study contributes to the literature on the performance of diagnosis‐related groups (DRGs) for acute myocardial infarction (AMI) patients by evaluating in nine countries the factors—in addition to DRGs—that affect costs or length of stay and comparing the variation that can be explained with or without DRGs. We evaluate whether the existing DRGs for AMI patients would benefit from additional patient‐related and treatment‐related factors that are found in administrative data across countries. In most countries, the set of patient and quality variables performed better than the DRG variables. Our results suggest that DRG systems in all countries could be improved by including additional explanatory factors or by refining the existing DRGs. Our results suggest that for AMI and possibly for other related episodes, a refinement of DRGs to include information on patient severity, procedures and levels of complications could improve the ability of DRGs to explain resource use. It seems possible to improve DRG‐like hospital payment systems through the inclusion of episode‐specific variables. Copyright © 2012 John Wiley & Sons, Ltd.

Suggested Citation

  • Unto Häkkinen & Pietro Chiarello & Francesc Cots & Mikko Peltola & Hanna Rättö & ON BEHALF OF THE EURODRG GROUP, 2012. "Patient Classification And Hospital Costs Of Care For Acute Myocardial Infarction In Nine European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 19-29, August.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:s2:p:19-29
    DOI: 10.1002/hec.2840
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    References listed on IDEAS

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    1. Brigitte Dormont & Carine Milcent, 2004. "The sources of hospital cost variability," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 927-939, October.
    2. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    3. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    4. Elena Polverejan & Joseph C. Gardiner & Cathy J. Bradley & Margaret Holmes‐Rovner & David Rovner, 2003. "Estimating mean hospital cost as a function of length of stay and patient characteristics," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 935-947, November.
    5. repec:dau:papers:123456789/5426 is not listed on IDEAS
    6. Voss, Gemma B. W. E. & Hasman, Arie & Rutten, Frans & de Zwaan, Chris & Carpay, Jan J., 1994. "Explaining cost variations in DRGs `Acute Myocardial Infarction' by severity of illness," Health Policy, Elsevier, vol. 28(1), pages 37-50, March.
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    Cited by:

    1. Carine Milcent, 2021. "From downcoding to upcoding: DRG based payment in hospitals," International Journal of Health Economics and Management, Springer, vol. 21(1), pages 1-26, March.
    2. Tor Iversen & Eline Aas & Gunnar Rosenqvist & Unto Häkkinen & on behalf of the EuroHOPE study group, 2015. "Comparative Analysis of Treatment Costs in EUROHOPE," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 5-22, December.
    3. Reinhard Busse & on behalf of the EuroDRG group, 2012. "DO DIAGNOSIS‐RELATED GROUPS EXPLAIN VARIATIONS IN HOSPITAL COSTS AND LENGTH OF STAY? – ANALYSES FROM THE EURODRG PROJECT FOR 10 EPISODES OF CARE ACROSS 10 EuroPEAN COUNTRIES," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 1-5, August.
    4. Unto Häkkinen & Gunnar Rosenqvist & Tor Iversen & Clas Rehnberg & Timo T. Seppälä & on behalf of the EuroHOPE study group, 2015. "Outcome, Use of Resources and Their Relationship in the Treatment of AMI, Stroke and Hip Fracture at European Hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 116-139, December.

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