-
Comparative Study
Patient classification and hospital reimbursement for inguinal hernia repair: a comparison across 11 European countries.
- L Serdén and J O'Reilly.
- Hernia. 2014 Apr 1; 18 (2): 273-81.
PurposeThis comparative study examines the categorisation of patients undergoing surgical repair of inguinal hernia in the diagnosis-related group (DRG) systems of 11 European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Spain and Sweden). Understanding the design and operation of DRG systems for this common surgical procedure is important, given their increasing use internationally for hospital reimbursement and performance measurement.MethodsA common definition was used to identify inguinal hernia patients and the corresponding data were extracted from national databases. The analysis compared the variables and algorithms for classifying these patients to DRGs across the participating countries, as well as the number, composition and relative resource intensity of groups. An index case and six standardised vignettes were grouped using each country’s DRG system and the associated quasi-prices were calculated.ResultsThe number of groups to which inguinal hernia patients are assigned is typically three or four, but ranges from two in Poland to ten in France. In most systems, categorising patients is contingent on procedure, principal and secondary diagnoses, and age, with treatment setting (day case/inpatient) being less common. Added to these, the French system also incorporates length of stay and whether the patient died. More resource intensive DRGs generally contained patients who were older, treated as inpatients, did not die, had (more severe) complications and/or co-morbidities, and/or underwent laparoscopic repair. There are cross-country disparities in day case rates and the use of laparoscopic repairs.ConclusionsThe categorisation of inguinal hernia patients varies across the 11 European DRG systems under study. By highlighting the main differences across these systems, this comparative analysis allows the relevant decision makers to assess the adequacy and specificity of their own DRG systems.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.