Learning from and Improving DRGs (Diagnosis Related Groups) for ESRD (End Stage Renal Disease) Patients

摘要

The study addressed how the implementation of Medicare's Prospective Payment System (PPS) for hospital inpatient care affected the Medicare End Stage Renal Disease (ESRD) program, ESRD providers, and ESRD patients. The main issues of concern were hospital utilization and program spending, together with patient access to care and quality. The project conducted numerous interrelated analyses of primary Medicare data on services to ESRD and other beneficiaries. The study's main findings are: Hospital admission rates for ESRD patients were unchanged after the introduction of PPS. However, total days of inpatient care declined, due to reductions in lengths of stay. Medicare hospital reimbursements per ESRD patient were generally up over the 1983-84 period. Hospital readmission rates for ESRD beneficiaries were not increased as a consequence of PPS. ESRD patient mortality did not increase as a consequence of PPS. ESRD patient access to hospital care was not affected by PPS.