Impact of the Diagnostic-Related Group Prospective Payment Systexn on the Outcome and Quality of Care of Elderly Patients Hospitalized with Pneumonia

Abstract

In order to determine whether the institution of the Medicare prospective payment system has led to poorer outcome and quality of care for patients hos pitalized with pneumonia at the Hershey Medical Center, a critical review of elderly pneumonia pa tients was performed for two time periods. The first time period was July 1981 through June 1982 (pre- diagnostic-related group era). The second time period was July 1984 through June 1985 (diagnostic-re lated group era). There were no significant differ ences between these two groups in terms of age, se verity of illness, and mean length of stay. The number of deaths was virtually identical for each group (ap proximately 27% mortality overall). We were unable to show any differences in the quality of care by a structured process of care review. Thus, we conclude that the prospective payment system has not had a negative impact on outcome or quality of patient care in patients hospitalized with pneumonia at this uni versity hospital.