This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Pancreatic Pseudocyst: A Case in Point

Kim Ephgrave, MD; John Hunt, MD

Arch Surg. 1985;120(6):703-707.

Abstract
• Diagnosis-related groups (DRGs) have been mandated by the federal government to promote fiscal responsibility and insure cost containment. A retrospective analysis of demographic and cost data was conducted on 115 patients operated on for pancreatic pseudocyst. The DRG 191 criteria are as follows: major pancreas, liver plus shunt procedure; mean length of stay (LOS), 20.8 days; outlier cutoff LOS, 41 days; hospital reimbursement, $11,367.82; and day outlier rate, $86.57. The overall LOS was 34.6 days (range, one to 138 days). Sixty-six percent of the patients exceeded the DRG LOS and 37% exceeded the day outlier cutoff of 41. The number of days from admission to surgery varied from one to 65 (mean, 15.7 days). Hospital charges and DRG reimbursement were compared in 23 patients. In nine patients with a LOS of 19.9 days, DRG reimbursement exceeded charges by $34,308. In 14 patients whose charges exceeded reimbursement, the loss was $142,156. Hospital costs and LOS seem to be related to the natural history of the disease and its necessary treatment, rather than to unnecessary diagnostic procedures. Unless surgeons assess and establish medical standards, economic pressures will have a negative impact on patient care and physicians' practice.

(Arch Surg 1985;120:703-707)

Author Affiliations
From the Department of Surgery, University of Texas Health Science Center, Dallas.

Footnotes
Accepted for publication Feb 28, 1985.

Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1984.

Reprint requests to Department of Surgery, University of Texas Health Science Center, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Hunt).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Impact of Technology on the Management of Pancreatic Pseudocyst: Fifth Annual Samuel Jason Mixter Lecture
Walt et al.
Arch Surg 1990;125:759-763.
ABSTRACT