Age, resource consumption, and outcome for medical patients at an academic medical center. Academic Article uri icon

Overview

MeSH

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Costs and Cost Analysis
  • Federal Government
  • Hospital Bed Capacity, 500 and over
  • Humans
  • Length of Stay
  • Middle Aged
  • New York City
  • Patient Selection
  • Prospective Payment System

MeSH Major

  • Academic Medical Centers
  • Diagnosis-Related Groups
  • Health Resources
  • Outcome and Process Assessment (Health Care)
  • Resource Allocation

abstract

  • At the national level debate is growing about the effects of the diagnosis related group (DRG) hospital payment system on patient access and quality of care. Recent changes to the DRG system have dropped any stratification by age and have delayed any other major change to improve payment equity. We characterized hospital resource consumption and outcome by age for all medical admissions (N = 31,838) to a large academic medical center (January 1, 1985, through December 31, 1987) using the DRG format. Mean hospital cost per patient, hospital length of stay, percentage of outliers, and mortality increased with age. The mean DRG case-mix index and the number of diagnostic codes per patient also rose with age. The DRG payment for all patients would have produced an aggregate profit of $34,426,951 ($1081 profit per patient); however, patients aged 71 years or older generated loses (the highest with patients aged 85 years or older--a $2177 loss per patient). As the financial position of American hospitals continues to deteriorate, these data suggest that the current DRG payment scheme may be inequitable for the medical patient aged 71 years or older, thus providing financial disincentives to treat the elderly medical patient and perhaps limiting their access and quality of care in the future.

publication date

  • September 1989

has subject area

  • Academic Medical Centers
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Costs and Cost Analysis
  • Diagnosis-Related Groups
  • Federal Government
  • Health Resources
  • Hospital Bed Capacity, 500 and over
  • Humans
  • Length of Stay
  • Middle Aged
  • New York City
  • Outcome and Process Assessment (Health Care)
  • Patient Selection
  • Prospective Payment System
  • Resource Allocation

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed ID

  • 2505704

Additional Document Info

start page

  • 1946

end page

  • 1950

volume

  • 149

number

  • 9