Diagnostic-related groups: their impact on an inpatient rehabilitation program

Prospective payment by diagnostic-related groups (DRGs) was expected to result in early discharges from acute care hospitals. Early transfers of patients to rehabilitation programs were anticipated, since inpatient rehabilitation programs were exempt from the prospective payment plan. A retrospective study of 516 patient records at our hospital between July 1, 1983, and June 30, 1985, was undertaken to examine changes in the major parameters of the rehabilitation program. No changes in proportions of individuals by diagnostic group, age, or gender were found. No significant change in length of stay occurred. After prospective payment took effect, the average patient admitted to rehabilitation was more impaired regardless of age, yet patients over 65 years showed comparable functional levels at discharge. More medical complications during rehabilitation stay were noted. Most patients continued to return to a home environment. Most parameters did not change after the advent of DRGs.