Nursing dependency, diagnosis-related groups, and length of hospital stay

Most efforts to modify the diagnosis-related group (DRG) case classification system focus on variables related to medical management. In this study, we investigated the separate but related natures of medicine and nursing by examining 1,288 adult medical and surgical patients in an urban teaching hospital. The complexity of medical treatment was measured by use of the DRG relative cost weight. The nursing indicator was derived from a set of nursing diagnoses. We found that the DRG cost weight is a poor predictor of nursing dependency and that the nursing dependence index added significantly to the DRG weight in explaining length of stay.