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Childhood disorder DRG: consideration for a predictive model.

A E Christ, S Tsemberis, H Andrews

    Journal of the American Academy of Child and Adolescent Psychiatry
    |January 1, 1989
    PubMed
    Summary
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    The proposed child psychiatric Diagnosis Related Group (DRG) payment model is inadequate for many hospitalizations. A revised model considering service type is needed for equitable child psychiatric care reimbursement.

    Area of Science:

    • Healthcare Economics
    • Child Psychiatry
    • Hospital Administration

    Background:

    • Current Diagnosis Related Group (DRG) models may not accurately reflect the costs of child psychiatric hospitalizations.
    • Prepaid hospitalization models require accurate cost-based reimbursement to ensure quality care.

    Purpose of the Study:

    • To evaluate the appropriateness of the proposed DRG for child psychiatric hospitalizations.
    • To identify potential inequities in reimbursement based on current DRG proposals.
    • To propose an alternative DRG structure for more equitable payment.

    Main Methods:

    • Analysis of 2,266 child psychiatric admissions across eight New York City hospitals.
    • Comparison of proposed DRG mean length of stay (6.6 days) with actual data.

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  • Examination of interhospital variations in disposition resources and treatment strategies.

    • Main Results:

    • The proposed single mean DRG is unsuitable for psychiatric units, potentially causing underpayment for acute and long-term care.
    • Pediatric unit admissions with psychiatric diagnoses align with the proposed DRG.
    • A service-type category could define three DRGs for fairer reimbursement.

    Conclusions:

    • The current DRG proposal for child psychiatric care requires revision.
    • Reimbursement models must account for variations in care settings and treatment intensity.
    • Developing distinct DRGs based on service type is crucial for equitable child psychiatric healthcare funding.