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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

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  • Andrew Street
  • Conrad Kobel
  • Thomas Renaud
  • Josselin Thuilliez
  • ON BEHALF OF THE EURODRG GROUP

Abstract

We set out an analytical strategy to examine variations in resource use, whether cost or length of stay, of patients hospitalised with different conditions. The methods are designed to evaluate (i) how well diagnosis‐related groups (DRGs) capture variation in resource use relative to other patient characteristics and (ii) what influence the hospital has on their resource use. In a first step, we examine the influence of variables that describe each individual patient, including the DRG to which the patients are assigned and a range of personal and treatment‐related characteristics. In a second step, we explore the influence that hospitals have on the average cost or length of stay of their patients, purged of the influence of the variables accounted for in the first stage. We provide a rationale for the variables used in both stages of the analysis and detail how each is defined. The analytical strategy allows us (i) to identify those factors that explain variation in resource use across patients, (ii) to assess the explanatory power of DRGs relative to other patient and treatment characteristics and (iii) to assess relative hospital performance in managing resources and the characteristics of hospitals that explain this performance. Copyright © 2012 John Wiley & Sons, Ltd.

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  • 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.
  • Handle: RePEc:wly:hlthec:v:21:y:2012:i:s2:p:6-18
    DOI: 10.1002/hec.2837
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    5. Gerli Paat‐Ahi & Maria Świderek & Paweł Sakowski & Janek Saluse & Ain Aaviksoo & on behalf of the EURODRG group, 2012. "DRGs IN EUROPE: A CROSS COUNTRY ANALYSIS FOR CHOLECYSTECTOMY," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 66-76, August.
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    7. Carine Milcent, 2016. "Upcoding and heterogeneity in hospitals’ response: A Natural Experiment," PSE Working Papers halshs-01340557, HAL.
    8. Alexander Geissler & David Scheller‐Kreinsen & Wilm Quentin & on behalf of the EuroDRG group, 2012. "Do Diagnosis‐Related Groups Appropriately Explain Variations In Costs And Length Of Stay Of Hip Replacement? A Comparative Assessment Of Drg Systems Across 10 European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 103-115, August.
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    10. 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.
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    13. Thanassoulis, Emmanuel & Silva Portela, Maria & Graveney, Mike, 2016. "Identifying the scope for savings at inpatient episode level: An illustration applying DEA to chronic obstructive pulmonary disease," European Journal of Operational Research, Elsevier, vol. 255(2), pages 570-582.
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    15. Häkkinen, Unto & Rosenqvist, Gunnar & Peltola, Mikko & Kapiainen, Satu & Rättö, Hanna & Cots, Francesc & Geissler, Alexander & Or, Zeynep & Serdén, Lisbeth & Sund, Reijo, 2014. "Quality, cost, and their trade-off in treating AMI and stroke patients in European hospitals," Health Policy, Elsevier, vol. 117(1), pages 15-27.
    16. Bernal-Delgado, Enrique & Comendeiro-Maaløe, Micaela & Ridao-López, Manuel & Sansó Rosselló, Andreu, 2020. "Factors underlying the growth of hospital expenditure in Spain in a period of unexpected economic shocks: A dynamic analysis on administrative data," Health Policy, Elsevier, vol. 124(4), pages 389-396.
    17. Francesc Cots & Pietro Chiarello & Xavier Salvador & Xavier Castells & on behalf of the EuroDRG group, 2012. "Patient Classification Systems And Hospital Costs Of Care For Knee Replacement In 10 European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 116-128, August.
    18. Conrad Kobel & Engelbert Theurl, 2013. "Hospital specialisation within a DRG-Framework: The Austrian Case," Working Papers 2013-06, Faculty of Economics and Statistics, Universität Innsbruck.
    19. Jacqueline O'Reilly & Lisbeth Serdén & Mats Talbäck & Brian McCarthy & on behalf of the EuroDRG group, 2012. "Performance Of 10 European Drg Systems In Explaining Variation In Resource Utilisation In Inguinal Hernia Repair," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 89-101, August.
    20. James Gaughan & Anne Mason & Andrew Street & Padraic Ward, 2012. "English Hospitals Can Improve Their Use of Resources: An Analysis of Costs and Length of Stay for Ten Treatments," Working Papers 078cherp, Centre for Health Economics, University of York.
    21. Stefan Rabbe & Meilin Möllenkamp & Benedetta Pongiglione & Hedwig Blommestein & Pim Wetzelaer & Renaud Heine & Jonas Schreyögg, 2022. "Variation in the utilization of medical devices across Germany, Italy, and the Netherlands: A multilevel approach," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 135-156, September.
    22. 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.
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    25. David Scheller‐Kreinsen & on behalf of the EuroDRG group, 2012. "How Well Do Diagnosis‐Related Group Systems Group Breast Cancer Surgery Patients?—Evidence From 10 European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 41-54, August.

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