Diagnosis related groups and the critically injured

D. J. Kreis, D. Augenstein, J. M. Civetta, G. A. Gomez, J. J. Vopal, P. M. Byers

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


We reviewed the records of 59 patients with trauma treated in the surgical intensive care unit in 1983 to attempt to identify a diagnosis related group (DRG) modifier in order to eliminate major losses which would be incurred in caring for the critically injured. There were 22 females and 37 males. Payment based upon a DRG system would have resulted in hospital losses for the following subgroups: surgical treatment (n = 44) $1,348,009; no operation (n = 15) $125,085; length of stay (LOS) of more than ten days (n = 35) $1,124,778; LOS equal to or less than ten days (n = 24) $348,316; nonsurvivors plus LOS equal to or less than ten days plus operation (n = 12) $269,778, and survivor plus LOS greater than ten days plus operation (n = 29) $1,022,284. No useful modifier was identified for these subgroups using regression analysis. We believe that some immediate DRG modifier, based upon the total hospital charges (or costs if known) relationship to total DRG payments, should be created until further refinements in payment systems evolve. If some correction is not attempted, the considerable disadvantage which would result to participating hospitals may result in curtailing availability of effective long term intensive care unit trauma care at a time when the public is becoming aware of trauma systems and the improvement in survival seems to be a realizable goal.

Original languageEnglish (US)
Pages (from-to)317-322
Number of pages6
JournalSurgery Gynecology and Obstetrics
Issue number4
StatePublished - Jan 1 1987

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology


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