Prospective Payment System, based on DRGs (10th revision), started in Italy in January 1995. Neonatal DRGs are grouped under the Major Diagnostic Category n. 15 (MDC 15) and they do not consider birth weight as an important variable for classification. This is particularly worrisome since it is well known that birth weight is a major determinant of lenght of hospitalization and resource utilization. Furthermore several neonates end up in DRGs other than those of MDC 15. On the contrary birth weight is the main variable for newborn classification in the APDRGs system, wich groups all neonates only in the APMDC 15. The aim of this study was to evaluate the performance of DRGs and APDRGS in grouping the neonatal case-mix in a third level Children's Hospital and for that purpose we retrospectively selected 578 patients <29 days consecutively discharged from the Bambino Gesù Children's Hospital in 1995. With the DRGs system the patients were grouped in 19 different MDCs; only 41.8% ended up in the neonatal MDC 15; 84 different DRGs were necessary to group all patients. The APDRGs required only 27 DRGs for the classification of all patients. The homogeneity of the different groups in term of lenght of stay and therefore of resource consumption was better with APDRGs than DRGs. Our study shows that APDRGs classification system is better than DRGs for the description of the neonatal case-mix in a children's hospital and therefore should be preferentially utilized for financing purposes.
|Translated title of the contribution||Diagnosis Related Groups (DRGs) vs. All Patients Diagnosis Related Groups (APDRGs) in newborns classification|
|Number of pages||6|
|Journal||Rivista Italiana di Pediatria|
|Issue number||3 SUPPL.|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health