J Prev Med Public Health.  2011 Jan;44(1):48-55. 10.3961/jpmph.2011.44.1.48.

Impact of DRG Payment on the Length of Stay and the Number of Outpatient Visits After Discharge for Caesarean Section During 2004-2007

• Shon C
• Chung S
• Yi S
• Kwon S

• KMID: 1003039
• DOI: http://doi.org/10.3961/jpmph.2011.44.1.48

Abstract

OBJECTIVES
The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section.
METHODS
This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities.
RESULTS
The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge.
CONCLUSIONS
The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.

Keyword

DRG payment; Caesarean section; Difference in Differences method

MeSH Terms

Adolescent
Adult
Ambulatory Care/*economics/statistics & numerical data
Cesarean Section/*economics/statistics & numerical data
Diagnosis-Related Groups/*economics/statistics & numerical data
Fee-for-Service Plans/*economics/statistics & numerical data
Female
Humans
Insurance Claim Review
Length of Stay/*economics/statistics & numerical data
Middle Aged
Pregnancy
Young Adult