Psychiatric DRGs are identified in terms of their relative profitability within each hospital of a 386 hospital cohort. It is then determined whether hospitals admitted more of the more profitable and fewer of the less profitable patients over the period 1983-1987 (skimming). Also determined is whether hospitals discharged more of the less profitable to other short term hospitals over that same period of time (dumping). The findings generally indicate that this did not happen.
Get full access to this article
View all access options for this article.
References
1.
Ansell, D.A. & Schiff, R.L. (1987) Patient dumping: status implications and policy recommendation. Journal of theAmerican Medical Association , 257, 1500-1502.
2.
Berliner, H.S. (1988) Patient dumping - no one wins and we all lose. EditorialAmerican Journal of Public Health, 78, 1279-1280.
3.
Freidman, E. (1982) The "dumping" dilemma: finding what's fair. Hospitals, Sept.16, 75-84.
4.
Himmelstein, D.V., Woolhandler, S., Harnly, M., Bader, M.B., Silber, R., Backer, H.D. & Jones, A.A. (1984) Patient transfer: medical practice as social triage . American Journal of Public Health, 74, 494-497.
5.
Jencks, S.F., Horgun, C., Goldman, H.H. & Taube, C.A. (1987) Bringing excluded psychiatric facilities under the Medicare Prospective Payment System. Medical Care Supplement , 20, S1-S52.
6.
Jencks, S.F. & Bobula, J.D. (1988) Does receiving referral and transfer patients make hospitals expensive? Medical Care, 26, 948-958.
7.
Jonasson, O. & Barrett, J.A. (1987) Transfer of unstable patients: dumping or duty? Editorial, Journal of theAmerican Medical Association, 257, 1519.
8.
Kellerman, A.L. & Hackman, B.B. (1988) Emergency department patient "dumping": an analysis of interhospital transfers to the Regional Medical Center at Memphis, Tennessee . American Journal of Public Health, 78, 1287-1292.
9.
Long, M.J., Chesney, J.D., Ament, R.P., Desharnais, S.I., Fleming, S.T., Kobrinski, E.G. & Marshall, B.S. (1987) The effect of PPS on hospital product and productivity. Medical Care, 25, 528-538.
10.
Long, M.J., Chesney, J.D. & Fleming, S.T. (1992) Profitable and unprofitable DRGs: the implications for access. Health Services Management Research, in press.
11.
Munoz, E., Soldano, R., Gross, H., Chaflin, D., Muloy, D. & Wise, L. (1988) Diagnosis-related groups and the transfer of general surgical patients between hospitals. Archives ofSurgery, 123, 68-71.
12.
Relman, A.S. (1986) Texas eliminates dumping: a start toward equity in hospital care. New England Journal of Medicine, 314, 578-579.
13.
Schiff, R.L., Ansell, D.A., Schlosser, J.E., Idris, A.H., Morrison, A. & Whitman, S. (1986) Transfers to a public hospital: a prospective study of 467 patients. New England Journal of Medicine, 314, 552-557.
14.
Sloan, F.A., Morrissey, M.A. & Valvona, J. (1988) Case shifting and Medicare prospective payment system. American Journal of Public Health, 78, 553-556.
