Document Detail

Reimbursement for intensive care services under diagnosis-related groups.
MedLine Citation:
PMID:  3129234     Owner:  NLM     Status:  MEDLINE    
Current governmental policy, in an effort to reduce the federal deficit, has switched to a prospective payment system for hospital care of Medicare patients based on Diagnosis-Related Groups (DRGs). In New Jersey, all hospital care is reimbursed using a DRG system. This study examines the relationship between charges and reimbursement in a university hospital ICU under a DRG system for the care of patients who consume a large amount of the ICU resources. For patients who were classified Class IV under the Therapeutic Intervention Scoring System, with the possible exception of open heart patients, the charges for care delivered exceeded income received, with a net revenue of -$24,098 and an adjusted net revenue of -$5,057 for ICU Class IV patients (excluding open hearts). Thus, it appears that the care given to these patients may have resulted in a financial loss to the institution. If this were to continue, the financial impact might have a negative effect upon attempts to regionalize intensive care services.
C Bekes; S Fleming; W E Scott
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  16     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1988 May 
Date Detail:
Created Date:  1988-06-02     Completed Date:  1988-06-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  478-81     Citation Subset:  AIM; IM    
Department of Anesthesia, Cooper Hospital/University Medical Center, Camden, NJ 08103.
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MeSH Terms
Critical Care / economics
Diagnosis-Related Groups*
Intensive Care Units / economics*
Length of Stay
Middle Aged
New Jersey
Prospective Payment System / economics*

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