Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy

Abstract

PurposeThe implementation of the Korean diagnosis-related groups (DRG) payment system has been recently introduced in selected several diseases including appendectomy in Korea. Here, we report the early outcomes with regard to clinical aspects and medical costs of the Korean DRG system for appendectomies in Seoul Metropolitan Government - Seoul National University Boramae Medical Center throughout comparing before and after introduction of DRG system.MethodsThe DRG system was applied since January 2013 at our institute. After the DRG system, we strategically designed and applied our algorithm for the treatment of probable appendicitis. We reviewed the patients who were treated with a procedure of appendectomy for probable appendicitis between July 2012 and June 2013, divided two groups based on before and after the application of DRG system, and compared clinical outcomes and medical costs.ResultsTotal 416 patients were included (204 patients vs. 212 patients in the group before vs. after DRG). Shorter hospital stays (2.98 ± 1.77 days vs. 3.82 ± 1.84 days, P < 0.001) were found in the group after DRG. Otherwise, there were no significant differences in the perioperative outcomes and medical costs including costs for first hospitalization and operation, costs for follow-up after discharge, frequency of visits of out-patient's clinic or Emergency Department or rehospitalization.ConclusionIn the Korean DRG system for appendectomy, there were no significant differences in perioperative outcomes and medical costs, except shorter hospital stay. Further studies should be continued to evaluate the current Korean DRG system for appendectomy and further modifications and supplementations are needed in the future.

Does Korea's current diagnosis-related group-based reimbursement system appropriately classify appendectomy patients?

“…The LOS-reducing effect of the DRG system could be attributed to the characteristics of DRGs that provide hospitals with incentive to reduce per patient costs. Our results are consistent with a previous report on Korean DRG-based payment for appendicitis [ 7 ]. Recently, Cheng et al [ 1 ] conducted a study using a nationwide, population-based dataset to examine the impacts of the Taiwan DRG-based payment system for coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty.…”

Effects of a mandatory DRG payment system in South Korea: Analysis of multi-year nationwide hospital claims data

“…This study explored four items reflective of patient care (LOS, total medical costs, shifting services to outpatient settings, and readmission rates). These items have often been utilized in studies of DRG effects in Korea [15, 20–23]. We assessed LOS using admission date and discharge date.…”

Characteristics and related factors of emergency department visits, readmission, and hospital transfers of inpatients under a DRG-based payment system: A nationwide cohort study

“…After implementing DRG-based payment systems in the USA, Germany, Korea, and other countries, the average length of hospitalization was significantly reduced [3][4][5][6]. Some studies have analyzed this based on specific or common surgical cases, and the results showed that healthcare quality either improved or showed no significant change after system implementation [7][8][9]. In addition to the common measure of "length of hospitalization," healthcare quality indicators also include the post-discharge readmission rate (such as ED visits and readmission rate), hospital transfer rate, and intensity of care (i.e., the number of orders during one's hospitalization) [7][8][9].…”