Table 3.
Adverse outcomes resulting from the implementation of reimbursement mechanisms based on the diagnosis-related group classification system14–24,32–49
| Author and year of study | Setting | Type of study | Outcome | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Quality of care | Access to care | Efficiency of care | ||||||||
| Early discharge | Readmission rate | Length of stay | Service provision | Mortality rate | Admission rate | Efficiency | Transfer of costs | |||
| Busato and von Below14 (2010) | Switzerland | Quantitative | N/A | Increased | Decreased | N/A | Decreased | Decreased | N/A | No effect |
| Rogers et al.15 (1990) | USA | Quantitative | Increased | N/A | N/A | N/A | No effect | No effect | N/A | Increased |
| Vulgaropulos et al.16 (1990) | USA | Quantitative | N/A | N/A | Increased | N/A | N/A | N/A | Inefficient | N/A |
| Evans et al.17 (1990) | USA | Quantitative | Increased | No effect | Decreased | No effect | N/A | N/A | N/A | Increased |
| Goldberg and Estes18 (1990) | USA | Mixedmethod | Increased | N/A | N/A | N/A | N/A | Decreased | N/A | Increased |
| Tresch et al.19 (1988) | USA | Quantitative | Increased | Increased | Decreased | N/A | N/A | N/A | N/A | Increased |
| Lyles20 (1986) | USA | Mixed-method | Increased | N/A | N/A | N/A | Increased | N/A | N/A | Increased |
| Hurley et al.21 (1990) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Increased |
| Menke et al.22 (1998) | USA | Quantitative | Increased | Increased | Decreased | N/A | N/A | N/A | N/A | Increased |
| Gay and Kronenfeld23 (1990) | USA | Quantitative | Increased | Increased | Decreased | N/A | Decreased | Decreased | N/A | Increased |
| Morrisey et al.24 (1988) | USA | Quantitative | N/A | N/A | Decreased | N/A | N/A | N/A | N/A | Increased |
| Zhan et al.32 (2007) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Wisensale and Waldron33 (1991) | USA | Qualitative | Increased | N/A | N/A | N/A | N/A | Decreased | N/A | N/A |
| Muñoz et al.34 (1989) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | Decreased | Inefficient | N/A |
| Muñoz et al.35 (1988) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | Decreased | Inefficient | Increased |
| Zwanziger et al.36 (1991) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Vollertsen et al.37 (1988) | USA | Quantitative | N/A | N/A | Decreased | N/A | N/A | N/A | N/A | Increased |
| Horn et al.38 (1986) | USA | Quantitative | N/A | N/A | Decreased | N/A | N/A | Decreased | Inefficient | N/A |
| Thomas et al.39 (1988) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Pasternak et al.40 (1986) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Bull41 (1988) | USA | Qualitative | Increased | N/A | N/A | N/A | N/A | N/A | N/A | Increased |
| Joy and Yurt42 (1990) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Muñoz et al.43 (1988) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Munoz et al.44 (1989) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Munoz et al.45 (1989) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Muñoz et al.46 (1989) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Hensen et al.47 (2005) | Germany | Quantitative | Increased | N/A | N/A | N/A | N/A | N/A | Inefficient | N/A |
| Patel48 (1988) | USA | Quantitative | Increased | N/A | N/A | Decreased | N/A | N/A | N/A | N/A |
| Wolfe and Detmer49 (1988) | USA | Quantitative | N/A | N/A | N/A | N/A | N/A | Decreased | N/A | N/A |
N/A = not available.