The Effects of the DRG-based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients

An Introduction to the Series

Published in: JAMA, Journal of the American Medical Association, v. 264, no. 15, Oct. 17, 1990, p. 1953-1954

Posted on on January 01, 1990

by Katherine L. Kahn, Lisa V. Rubenstein, David Draper, Jacqueline Kosecoff, William H. Rogers, Emmett B. Keeler, Robert H. Brook

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In 1985, the authors began a 4-year evaluation of the effects of the diagnosis related groups-based prospective payment system on quality of care for hospitalized Medicare patients. This article provides an overview of the study's background, aims, design, and methods. The authors used a clinically detailed review of the medical record supplemented by data on postdischarge outcomes drawn from the files of the Health Care Financing Administration and fiscal intermediaries to (1) compare outcomes of care after adjustment for sickness at admission, (2) assess the process of in-hospital care and relationships between processes and outcomes, and (3) assess status at discharge for a nationally representative sample of patients hospitalized before and after prospective payment was implemented.

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