Abstract
Background
The diagnosis-related group (DRG) is a payment system introduced to standardize healthcare costs. However, reimbursement for treatment of infections does not always cover costs.Methods
We used 2015-2018 data from 92 US hospitals in the Becton Dickinson Insights Research Database to compare the financial burden of hospital admissions within non-infection DRGs for patients with a bacterial infection (INF+) versus those without an infection (INF-). Included patients were adults with a hospital length of stay (LOS) ≥3 days and evidence of infection. Multi-variable adjusted analyses via generalized linear mixed models were used to evaluate the impact of an infection on outcomes.Results
We analyzed data from 133,423 INF+ admissions and 170,531 INF- admissions. Infections were associated with an approximately two-fold increase in model-estimated LOS (9.2 vs 4.8 d; P < .001) and intensive care unit LOS (5.1 vs 2.8 d; P < .001). The average additional hospital cost for INF+ versus INF- admissions was $10,326 per admission (P < .001) and the average loss after reimbursement was $1,067 (P = .006). Only private insurance payers had a positive margin.Conclusions
Current reimbursement options for infections result in significant hospital financial burden. Reimbursement models should be reconsidered to enable adoption of costlier diagnostics and antimicrobials.Citations & impact
Impact metrics
Alternative metrics
Discover the attention surrounding your research
https://www.altmetric.com/details/107009444
Smart citations by scite.ai
Explore citation contexts and check if this article has been
supported or disputed.
https://scite.ai/reports/10.1016/j.ajic.2021.04.007
Article citations
Does the disclosure of medical insurance information affect patients' willingness to adopt the diagnosis related groups system.
Front Public Health, 11:1136178, 21 Aug 2023
Cited by: 0 articles | PMID: 37670832 | PMCID: PMC10475549
Similar Articles
To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.
Which Clinical and Patient Factors Influence the National Economic Burden of Hospital Readmissions After Total Joint Arthroplasty?
Clin Orthop Relat Res, 475(12):2926-2937, 01 Dec 2017
Cited by: 57 articles | PMID: 28108823 | PMCID: PMC5670047
Academic health systems management: the rationale behind capitated contracts.
Ann Surg, 231(6):849-859, 01 Jun 2000
Cited by: 14 articles | PMID: 10816628
Is it financially beneficial for hospitals to prevent nosocomial infections?
BMC Health Serv Res, 20(1):653, 14 Jul 2020
Cited by: 7 articles | PMID: 32664922 | PMCID: PMC7358996
How diagnosis-related group 559 will change the US Medicare cost reimbursement ratio for stroke centers.
Stroke, 38(4):1309-1312, 01 Mar 2007
Cited by: 28 articles | PMID: 17332446
Hospital-acquired infections in Belgian acute-care hospitals: financial burden of disease and potential cost savings.
Acta Clin Belg, 68(3):199-205, 01 May 2013
Cited by: 3 articles | PMID: 24156220