Hospital cost, resource use, and diagnostic related groups for gynecology patients

The purpose of this study was to analyze hospital resource consumption by age for gynecology patients and to examine whether the assumptions made when the Diagnostic Related Groups payment was structured appear to be valid for our hospital. All gynecology admissions (N = 2232) at a large academic medical center during a 15-month period were analyzed by age using the Diagnostic Related Group format. Older patients generally consumed a disproportionately higher share of resources. Length of hospital stay, intensive care unit use, blood transfusion requirements, and overall hospital cost generally increased with age. Although mean Diagnostic Related Group reimbursement per patient also rose with age, it plateaued for patients 65 years of age and older. However, our hospital did not sustain a loss in providing care under Diagnostic Related Groups for older patients, except for the group of patients between the ages of 75-79 years. Although older gynecology patients generally had higher hospital resource consumption than younger patients, the current Diagnostic Related Group system seemed to adequately reimburse our hospital for their care.