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ISSN: 2161-0665

Pediatrics & Therapeutics
Open Access

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Research Article

Using All Patient Refined Diagnosis Related Group to Identify Cost-Management Targets

Brian Benneyworth, Mark Rigby, Mary Heskett, Aaron Carroll and Mara Nitu*

Department of Pediatrics, Indiana University School of Medicine, USA

*Corresponding Author:
Mara E Nitu
Associate Professor of Clinical Pediatrics
Clinical Chief, Section of Pediatric Critical Care
Riley Hospital for Children at Indiana University Health
Indiana University School of Medicine, 705 Riley Hospital Drive
RI 4909, Indianapolis, Indiana 46202-5225, USA
Tel: 317- 948-2802
Fax: 317-944-3442
E-mail: [email protected]

Received Date: September 10, 2014; Accepted Date: October 27, 2014; Published Date: October 29, 2014

Citation: Benneyworth B, Rigby M, Heskett M, Carroll A, Nitu M (2014) Using All Patient Refined Diagnosis Related Group to Identify Cost- Management Targets . Pediat Therapeut 4:217. doi:10.4172/2161-0665.1000217

Copyright: © 2014 Benneyworth B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Background: Evaluate patterns in existing cost data for patients with respiratory illness managed in a large academic Pediatric Intensive Care Unit (PICU), with the goal to identify targets for potential cost-management strategies.

Methods: Retrospective, observational study of patients admitted to a 34-bed multidisciplinary PICU from October 2011 to September 2012. Study design: Variable direct costs (VDC) for each All Patient Refined Diagnosis Related Group (APR DRG) were obtained from the Decision Support Group and detailed analysis was performed for top respiratory APR DRGs. Results: During the study period, 1,999 patients were admitted to the PICU equating to 17,053 PICU days. Medical critical care patients accounted for 54% of all admissions and 46% PICU days. The top 5 respiratory-related APR DRGs accounted for almost 45% of all PICU medical admissions. Non-asthma respiratory-related APR DRGs accounted for 23% of medical admission and 18% of medical PICU days. Of the total VDC for this subgroup, 54% and 20% was attributed to nursing and respiratory care respectively, with a significant minority (<10% ) on pharmacy and laboratory services. Further analysis of the VDC for respiratory care indicated one-third of all costs are incurred for pulmonary hygiene care, another third for delivery of bronchodilator therapy, and just 16.4% for mechanical ventilation. Conclusion: Analysis of VDC in context of APR DRG can indicate areas for potential cost management strategies. A high percentage of respiratory care costs accounted for pulmonary clearance interventions. This type of cost analysis may identify potential targets for cost-management interventions in various PICU populations.


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