Cost analysis of acute myocardial infarction management in DRG and PRG

Journal of Clinical and Basic Cardiology 2000; 3 (1): 23-28

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Keywords: akuter Myokardinfarkt,  Kostenanalyse,  acute myocardial infarction,  cost analysis,  DRG,  PRG

The cost of diagnostic and therapeutic procedures in patients with acute myocardial infarction (AMI) during hospitalization was determined using both the Diagnosis Related Group (DRG) and Process Related Group (PRG) systems. This cost-analysis system was planned and performed to estimate the cost of medical and non-medical staff involved in patient care and the cost of commisurables. In a 3 month period, 45 patients discharged with diagnosis of AMI, equivalent to 410 code ICD-9-CM, were enrolled in the study. Data collected were then elaborated and costs for each DRG were derived. The mean cost sustained for patient with AMI was 3062,32 ECU with a maximum of 8949,50 ECU for DRG 112 and a minimum of 1740,11 ECU for DRG 123. Our data suggest that, in patients with AMI a deep discrepancy between the DRG reimbursements and the ?real? cost, for example for DRG 112 (a discrepancy equivalent to 166 %), exists. The cost difference is essentially related to different procedures involved in medical care; it follows that global cost of patients with AMI is primarily related to PRG cost and is largely independent from other components. These results prove that therapeutic strategies are very important to determine cost for each DRG and that the cost for each DRG can change in relation to PRG performed and to progress of the disease. The utilization of DRG and PRG systems appear to be an essential tool to build up a system in which not only efficiency but also quality of care are evaluated. J Clin Basic Cardiol 2000; 3: 23-8.