Relating Nursing Care Requirements to Diagnosis Related Groups (DRGs)
Final rept. 1 Jan-31 Jul 1991
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE STUDIES DIV
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The implementation of the prospective payment system PPS to reimburse medical treatment facilities MTFs for care provided had a definite impact on health care facilities. According to the PPS, payments to health care facilities include coverage for all aspects of the provision of health care, including the care provided by nurses. With the costs of nursing labor continually rising, health care executives must become familiar with the costs of providing nursing care to patients. Birch and Davis 1990 conducted a study of nursing care hours required for 80 percent of cases treated in US Army MTFs. They noted a strong correlation, with the exception of four DRGs, between total nursing care hours and acuity. This study analyzed the nursing care hours NCHs required for DRGs 138 and 139 at Wilford Hall USAF Medical Center and compared the results with those found in the Birch and Davis study. Analysis at the diagnosis and the DRG level did not reveal significant variations in NCHs. Total NCHs were found to be strongly related to patient acuity for both DRGs but not strongly related to LOS in either.
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