Does Korea's current diagnosis-related group-based reimbursement system appropriately classify appendectomy patients?

Area of Science:

• Healthcare economics
• Surgical outcomes research

Background:

• The Korean diagnosis-related group (DRG) payment system was implemented for appendicitis care.
• Assessing the early outcomes of this system is crucial for potential improvements.

Purpose of the Study:

• To evaluate the impact of the Korean DRG payment system on appendicitis treatment outcomes.
• To identify factors influencing total in-patient costs post-DRG implementation.

Main Methods:

• Retrospective analysis of clinical data from Korean patients undergoing appendectomy.
• Comparison of outcomes before and after DRG system implementation.
• Univariate and multivariate analyses to determine cost-influencing factors.

Main Results:

• The DRG system significantly reduced postoperative length of stay (P < 0.001).
• Total in-hospital costs were not reduced by the DRG system.
• Patient age (≥70 years) and operation time (>100 minutes) were independent factors for higher costs.
• Older patients had significantly higher comorbidity risk (P < 0.001) and increased total in-hospital costs (P < 0.001).

Conclusions:

• Older patients (≥70 years) present with greater comorbidities, leading to elevated inpatient costs.
• Patient age should be considered as a variable in the DRG classification for appendicitis.