Performance of 10 European drg systems in explaining variation in resource utilisation in inguinal hernia repair.
Summary of "Performance of 10 European drg systems in explaining variation in resource utilisation in inguinal hernia repair."
By classifying hospital output into groups of patients with similar clinical characteristics and resource requirements, diagnosis-related groups (DRGs) are designed to be highly correlated with resource utilisation. Using a two-stage approach to control for variation within and between hospitals, we examine the ability of the diverse DRG systems in 10 European countries to explain variability in resource utilisation (costs or length of stay, LoS) for hospital patients undergoing surgical repair of inguinal hernia. Our national regression results suggest that DRGs are statistically significant in explaining cost/LoS variation in the absence of any other regressors and generally remain so in most countries when patient-level characteristics are added to the model. However patient-level characteristics, including those used in DRG assignment, are usually also statistically significant. In nine countries, where the number of relevant DRGs ranges from two (Poland) to seven (France), the inclusion of patient-level characteristics substantially improves model goodness-of-fit compared with that attained with DRGs alone. Only in Sweden is the converse true. If our analysis raises some concerns over the adequacy of DRGs to explain cost/LoS variation in inguinal hernia repair in nine of the 10 European countries, further research is required to consider whether future enhancements may be necessary. Copyright © 2012 John Wiley & Sons, Ltd.
Affiliation
Economic and Social Research Institute, Dublin, Ireland. jacqueline.oreilly@esri.ie.
Journal Details
This article was published in the following journal.
Name: Health economics
ISSN: 1099-1050
Pages: 89-101
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22815115
- DOI: http://dx.doi.org/10.1002/hec.2839
Medical and Biotech [MESH] Definitions
Inguinal Canal
The tunnel in the lower anterior ABDOMINAL WALL through which the SPERMATIC CORD, in the male; ROUND LIGAMENT, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring.
Hernia, Inguinal
An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.
European Union
The collective designation of three organizations with common membership: the European Economic Community (Common Market), the European Coal and Steel Community, and the European Atomic Energy Community (Euratom). It was known as the European Community until 1994. It is primarily an economic union with the principal objectives of free movement of goods, capital, and labor. Professional services, social, medical and paramedical, are subsumed under labor. The constituent countries are Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, and the United Kingdom. (The World Almanac and Book of Facts 1997, p842)
Spermatic Cord
Either of a pair of tubular structures formed by DUCTUS DEFERENS; ARTERIES; VEINS; LYMPHATIC VESSELS; and nerves. The spermatic cord extends from the deep inguinal ring through the INGUINAL CANAL to the TESTIS in the SCROTUM.
Salamandra
A genus of European newts in the Salamandridae family. The two species of this genus are Salamandra salamandra (European "fire" salamander) and Salamandra atra (European alpine salamander).
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