Diagnosis-Related Group in Colon Surgery

Identifying Areas of Improvement to Drive High-Value Care

Byron D. Hughes, Samantha A. Moore, Hemalkumar Mehta, Yong Shan, Anthony J. Senagore

Research output: Contribution to journalArticle

Abstract

Diagnosis-related group (DRG) migration is defined as the reassignment of colectomy patients from DRG 331 to 330 based exclusively on postoperative complications. Strategic and comparative application of this metric has the potential to demonstrate baseline and excessive rates of complications related directly to patient care differences across institutions. The aim of this study was to report the variability of DRG migration across United States hospitals and its impact on overall cost and length of stay (LOS). This study investigated the variability of DRG migration rates across United States hospitals polling 5 per cent of the national Medicare data. The study endpoints were total cost, LOS, and DRG migration rate. Hospitals were classified into tertiles for low (0.1-16.6%), moderate (16.7-23.0%), and high (23.1-83.3%) DRG migration rates. The study included 5120 patients from 615 hospitals. DRG migration rates for hospitals ranged from 0.1 per cent to 83.3 per cent, with 157 in the low, 183 in the moderate, and 364 in the high tertile. DRG migration resulted in a progressively increased LOS and hospital costs from the lowest to highest tertile. Several diagnoses were identified which are suggestive of failure to integrate evidence-based processes of care across the tertiles. The data confirm a wide variation in DRG migration rates from DRG 331 to 330 based only on postoperative complications. These ranges allow for the potential definition of both best practice, and opportunities for quality improvement with respect to postoperative complications, identification of hospital outliers, and the economics of care as part of a value-based care program.

Original languageEnglish (US)
Pages (from-to)256-260
Number of pages5
JournalThe American surgeon
Volume85
Issue number3
StatePublished - Mar 1 2019

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Diagnosis-Related Groups
Colon
Length of Stay
State Hospitals
Hospital Economics
Costs and Cost Analysis
Colectomy
Hospital Costs
Medicare
Quality Improvement
Practice Guidelines
Patient Care

ASJC Scopus subject areas

  • Surgery

Cite this

Hughes, B. D., Moore, S. A., Mehta, H., Shan, Y., & Senagore, A. J. (2019). Diagnosis-Related Group in Colon Surgery: Identifying Areas of Improvement to Drive High-Value Care. The American surgeon, 85(3), 256-260.

Diagnosis-Related Group in Colon Surgery : Identifying Areas of Improvement to Drive High-Value Care. / Hughes, Byron D.; Moore, Samantha A.; Mehta, Hemalkumar; Shan, Yong; Senagore, Anthony J.

In: The American surgeon, Vol. 85, No. 3, 01.03.2019, p. 256-260.

Research output: Contribution to journalArticle

Hughes, BD, Moore, SA, Mehta, H, Shan, Y & Senagore, AJ 2019, 'Diagnosis-Related Group in Colon Surgery: Identifying Areas of Improvement to Drive High-Value Care', The American surgeon, vol. 85, no. 3, pp. 256-260.
Hughes BD, Moore SA, Mehta H, Shan Y, Senagore AJ. Diagnosis-Related Group in Colon Surgery: Identifying Areas of Improvement to Drive High-Value Care. The American surgeon. 2019 Mar 1;85(3):256-260.
Hughes, Byron D. ; Moore, Samantha A. ; Mehta, Hemalkumar ; Shan, Yong ; Senagore, Anthony J. / Diagnosis-Related Group in Colon Surgery : Identifying Areas of Improvement to Drive High-Value Care. In: The American surgeon. 2019 ; Vol. 85, No. 3. pp. 256-260.
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