[Characteristics of hospitalization of aged patients before and after introduction of the prospective payment (DRG-ROD system). Researchers of the Italian Group of Pharmaco-epidemiology in the Aged (GIFA)]

Abstract

Using data collected by the Italian Group of Pharmacoepidemiology in the Elderly (Gruppo Italiano di Farmacoepidemiologia nell' Anziano-GIFA) from 1988 to 1995, we analyzed the variation of the most important characteristics of Italian hospitalized patients, such as length of hospital stay, appropriateness of hospital admission, in-hospital mortality, Charlson's comorbidity score. A number of quality of care indexes such as readmission rate, independence in daily activities at discharge, waiting periods for a specific instrumental examination or specialist consultation, were also analyzed. We studied the variations of these parameters in this population after the Diagnosis Related Groups (DRGs) system of payment was introduced. This analysis shows that in Italy factors related to hospital organization, and not patients, pathobiological characteristics, are the chief determinants of length of hospital stay.