- 作者：Jong Wan Kim ; MD ; Dong Woo Shin ; MD ; Jin Ju Chae ; BN ; Jeong Yeon Kim ; MD ; Sung Gil Park ; MD ; PhD ; pmcgpark@hallym.or.kr" class="auth_mail" title="E-mail the corresponding author
- 关键词：Diagnosis related group (DRG) ; Prospective payment system (PPS) ; Acute appendicitis ; Laparoscopic appendectomy
- 刊名：Journal of Surgical Research
- 出版年：2015
- 出版时间：December 2015
- 年：2015
- 卷：199
- 期：2
- 页码：338-344
- 全文大小：232 K
Methods
We included patients who underwent laparoscopic appendectomy at Dongtan Sacred Heart Hospital, Korea, between November 2012 and February 2014. The patients were divided into two groups: before-DRG/PPS or after-DRG/PPS groups. The length of the postoperative hospital stay (LOS) and medical costs were indicators of the medical resources. Medical costs included those of the initial hospital stay, outpatient clinic, readmission, and the sum of these charges. Complication and readmission rates were indicators of the rates of adverse events.
Results
After the implementation of the DRG/PPS, length of the hospital stay decreased by 10% (4.9 d before versus 4.4 d after DRG/PPS; P < 0.001). The initial hospital stay and total cost were significantly lower in the after-DRG/PPS group (both P < 0.001). The complication rates during the initial hospital stay (3.5% before versus 2.3% after DRG/PPS; P = 0.225) and the readmission rates (4.3% versus 2.5%, respectively; P = 0.227) were statistically similar.
Conclusions
This study shows that the K-DRG/PPS for laparoscopic appendectomy had no negative effect on the rate of adverse events and reduced the use of medical resources. Further evaluation of other procedures is required to determine the overall effects of the K-DRG/PPS.