Childhood Disorder DRG: Consideration for a Predictive Model

Abstract

The proposed Diagnosis Related Group (DRG) for prepaid child psychiatric hospitalizations is based on a mean length of stay of 6.6 days. This study examined data on 2,266 admissions to four state and four municipal hospitals providing child psychiatric care to residents of New York City. The results indicate: (1) use of this single mean is only appropriate for youngsters admitted to pediatric units and discharged with a psychiatric diagnosis but would result in substantial underpayment for acute and long-term care in psychiatric units; (2) a category reflecting type of service could be used to define a set of three DRGs that would provide more equitable reimbursement. Payment inequities arising from interhospital differences in disposition resources and treatment strategies are discussed. © 1989, The American Academy of Child and Adolescent Psychiatry. All rights reserved.