Am J Psychiatry 1986; 143:131-139
Copyright © 1986 by American Psychiatric Association
Diagnosis-related groups and general hospital psychiatry: the APA Study
JT English, SS Sharfstein, DJ Scherl, B Astrachan and IL Muszynski
Psychiatric units in general hospitals are exempt from diagnosis- related
groups (DRGs), a system of per case prospective payment that is used for
the majority of patients covered by Medicare. The American Psychiatric
Association purchased a large hospital discharge data base and studied the
potential impact of DRGs on psychiatric patients and inpatient psychiatric
units in general hospitals. There was substantial inaccuracy in the
psychiatric DRGs' prediction of resource use, which could lead to
inappropriate discharge of patients and financial risk to hospitals that
treat more severe cases. The authors advocate further research because
psychiatry must anticipate prospective payment in the future.
