The effect of Tw-DRGs implementation on medical quality and resource consumptions of patients with coronary artery disease

• Main Authors: Fei Yun Yu, 游斐雲
• Other Authors: K. H. Hsu
• Format: Others
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/87424133676684356357

碩士 === 長庚大學 === 商管專業學院碩士學位學程在職專班醫務管理組 === 101 === Objective: To investigate the changes of medical quality and medical consumption of patients who underwent cardiac catheterization, coronary angioplasty and coronary artery bypass graft surgery after the Tw-DRGs was implemented. Methods: This study collected 3,467 subjects who had received cardiac catheterization, coronary angioplasty, or coronary bypass surgery in a medical center in northern Taiwan, from January to December 2009 and January 2011 to June 2012.The outcome measurement involved re-hospitalization, revisits, death, and medical expenses. Results: After the Tw-DRGs was implemented mortality and readmission had no statistically significant difference. Indicating the quality of cardiac catheterization, coronary angioplasty, and coronary artery bypass surgery were not significantly affected. As to the medical consumptions, the total hospitalization cost of patients undergoing cardiac catheterization and coronary artery bypass surgery decreased; only that of patients undergoing coronary angioplasty increased. Conclusion: The implementation of Tw-DRGs under global budget has prompted the improvements of system management and cost containment in different level of hospitals facing different financial risk. The system has changed the practice pattern of providers to a more efficiency and cost managing manner. A more comprehensive and accurate medical record system can also benefit the financial performance of a hospital. This study provides an empirical evidence to support the effectiveness of current Tw-DRGs with features of cost minimization and medical quality sustainment.