The impact of introducing a new hospital financing system (DRGs) in Poland on hospitalisations for atherosclerosis: An interrupted time series analysis (2004–2012)
•Hospital payment based on DRGs was introduced in Poland in July 2008.•Following DRGs implementation, a sharp increase in hospitalisations for atherosclerosis was observed.•Non-public hospitals did not exhibit a rapid response to DRGs introduction.•Changes in the hospitalisation rates may be the res...
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| Veröffentlicht in: | Health policy (Amsterdam) 2017-11, Vol.121 (11), p.1186-1193 |
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| creator | Buczak-Stec, Elżbieta Goryński, Paweł Nitsch-Osuch, Aneta Kanecki, Krzysztof Tyszko, Piotr |
| description | •Hospital payment based on DRGs was introduced in Poland in July 2008.•Following DRGs implementation, a sharp increase in hospitalisations for atherosclerosis was observed.•Non-public hospitals did not exhibit a rapid response to DRGs introduction.•Changes in the hospitalisation rates may be the result of DRGs introduction.•Failure to account for these changes may result in incorrect epidemiological data.
Hospital payment based on diagnosis-related groups (DRGs) was introduced in Poland in July 2008. We evaluate the impact of this policy on the frequency of hospitalisation for atherosclerosis in internal medicine units of district hospitals and non-public hospitals in Poland.
Data were collected between 2004 and 2012 from each district and non-public hospital participating in the General Hospital Morbidity Study (165 hospitals in total). Atherosclerosis was defined using the ICD-10 code I70. Hospitalisation patterns were examined using interrupted time series with segmented regression analysis. Results were compared between public and non-public hospitals and across patient age groups.
The rate of hospitalisation for atherosclerosis rose by 27.05 per 10,000 total hospitalisations immediately following the implementation of DRGs in 2008. It then rose by 2.5 per 10,000 hospitalisations monthly between 2008–2012. The largest changes were observed for patients aged 85+ and 75–84. Rates rose by 117.5 and 54.2 per 10,000 hospitalisations in these two groups respectively following implementation of DRGs. The response to introduction of DRGs was less striking in non-public hospitals than in public hospitals.
Implementation of a DRG-based system in Poland was associated with substantial increases in atherosclerosis hospitalisation rates. Failing to take into account this change in financing and not accounting for long-term trends in hospitalisation rates may result in inaccurate epidemiological data. |
| doi_str_mv | 10.1016/j.healthpol.2017.09.009 |
| format | Article |
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Hospital payment based on diagnosis-related groups (DRGs) was introduced in Poland in July 2008. We evaluate the impact of this policy on the frequency of hospitalisation for atherosclerosis in internal medicine units of district hospitals and non-public hospitals in Poland.
Data were collected between 2004 and 2012 from each district and non-public hospital participating in the General Hospital Morbidity Study (165 hospitals in total). Atherosclerosis was defined using the ICD-10 code I70. Hospitalisation patterns were examined using interrupted time series with segmented regression analysis. Results were compared between public and non-public hospitals and across patient age groups.
The rate of hospitalisation for atherosclerosis rose by 27.05 per 10,000 total hospitalisations immediately following the implementation of DRGs in 2008. It then rose by 2.5 per 10,000 hospitalisations monthly between 2008–2012. The largest changes were observed for patients aged 85+ and 75–84. Rates rose by 117.5 and 54.2 per 10,000 hospitalisations in these two groups respectively following implementation of DRGs. The response to introduction of DRGs was less striking in non-public hospitals than in public hospitals.
Implementation of a DRG-based system in Poland was associated with substantial increases in atherosclerosis hospitalisation rates. Failing to take into account this change in financing and not accounting for long-term trends in hospitalisation rates may result in inaccurate epidemiological data.</description><identifier>ISSN: 0168-8510</identifier><identifier>EISSN: 1872-6054</identifier><identifier>DOI: 10.1016/j.healthpol.2017.09.009</identifier><identifier>PMID: 28967491</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Age differences ; Age groups ; Aged ; Aged, 80 and over ; Atherosclerosis ; Atherosclerosis - epidemiology ; Data collection ; Diagnosis-related groups ; Diagnosis-Related Groups - economics ; Diagnosis-Related Groups - statistics & numerical data ; Epidemiology ; Female ; Financing ; Health administration ; Health care reform ; Health policy change ; Hospitalization ; Hospitalization - statistics & numerical data ; Hospitals ; Hospitals, District - statistics & numerical data ; Hospitals, Private - statistics & numerical data ; Humans ; Implementation ; Internal medicine ; Interrupted time series ; Interrupted Time Series Analysis ; Male ; Medical diagnosis ; Medicine ; Middle Aged ; Morbidity ; Patients ; Poland ; Regression analysis ; Time series</subject><ispartof>Health policy (Amsterdam), 2017-11, Vol.121 (11), p.1186-1193</ispartof><rights>2017 Elsevier B.V.</rights><rights>Copyright © 2017 Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Nov 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-2df3bbcaa0539dc7e2ea96c7ba5d1c836e15aa73e40d8fdaa760b4c2c6d820b83</citedby><cites>FETCH-LOGICAL-c399t-2df3bbcaa0539dc7e2ea96c7ba5d1c836e15aa73e40d8fdaa760b4c2c6d820b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.healthpol.2017.09.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27866,27924,27925,30999,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28967491$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Buczak-Stec, Elżbieta</creatorcontrib><creatorcontrib>Goryński, Paweł</creatorcontrib><creatorcontrib>Nitsch-Osuch, Aneta</creatorcontrib><creatorcontrib>Kanecki, Krzysztof</creatorcontrib><creatorcontrib>Tyszko, Piotr</creatorcontrib><title>The impact of introducing a new hospital financing system (DRGs) in Poland on hospitalisations for atherosclerosis: An interrupted time series analysis (2004–2012)</title><title>Health policy (Amsterdam)</title><addtitle>Health Policy</addtitle><description>•Hospital payment based on DRGs was introduced in Poland in July 2008.•Following DRGs implementation, a sharp increase in hospitalisations for atherosclerosis was observed.•Non-public hospitals did not exhibit a rapid response to DRGs introduction.•Changes in the hospitalisation rates may be the result of DRGs introduction.•Failure to account for these changes may result in incorrect epidemiological data.
Hospital payment based on diagnosis-related groups (DRGs) was introduced in Poland in July 2008. We evaluate the impact of this policy on the frequency of hospitalisation for atherosclerosis in internal medicine units of district hospitals and non-public hospitals in Poland.
Data were collected between 2004 and 2012 from each district and non-public hospital participating in the General Hospital Morbidity Study (165 hospitals in total). Atherosclerosis was defined using the ICD-10 code I70. Hospitalisation patterns were examined using interrupted time series with segmented regression analysis. Results were compared between public and non-public hospitals and across patient age groups.
The rate of hospitalisation for atherosclerosis rose by 27.05 per 10,000 total hospitalisations immediately following the implementation of DRGs in 2008. It then rose by 2.5 per 10,000 hospitalisations monthly between 2008–2012. The largest changes were observed for patients aged 85+ and 75–84. Rates rose by 117.5 and 54.2 per 10,000 hospitalisations in these two groups respectively following implementation of DRGs. The response to introduction of DRGs was less striking in non-public hospitals than in public hospitals.
Implementation of a DRG-based system in Poland was associated with substantial increases in atherosclerosis hospitalisation rates. Failing to take into account this change in financing and not accounting for long-term trends in hospitalisation rates may result in inaccurate epidemiological data.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age differences</subject><subject>Age groups</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atherosclerosis</subject><subject>Atherosclerosis - epidemiology</subject><subject>Data collection</subject><subject>Diagnosis-related groups</subject><subject>Diagnosis-Related Groups - economics</subject><subject>Diagnosis-Related Groups - statistics & numerical data</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Financing</subject><subject>Health administration</subject><subject>Health care reform</subject><subject>Health policy change</subject><subject>Hospitalization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Hospitals, District - statistics & numerical data</subject><subject>Hospitals, Private - statistics & numerical data</subject><subject>Humans</subject><subject>Implementation</subject><subject>Internal medicine</subject><subject>Interrupted time series</subject><subject>Interrupted Time Series Analysis</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Patients</subject><subject>Poland</subject><subject>Regression analysis</subject><subject>Time series</subject><issn>0168-8510</issn><issn>1872-6054</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNqFkc9u1DAQhyMEokvhFcASl-0hYZz_5rYqpSBVAqFythx7QrxK7GA7oL3xDn0GXownwWHLHrhwsS35mxn__CXJCwoZBVq_2mcDijEMsx2zHGiTAcsA2INkQ9smT2uoyofJJpJt2lYUzpIn3u8BoCmK-nFylresbkpGN8nP2wGJnmYhA7E90SY4qxapzRciiMHvZLB-1kGMpNdGmD8X_uADTmT75tO1v4gl5KMdhVHEmhOtvQjaGk9664gIAzrr5biu2r8mO7MOQueWOaAiQU9IPDqNnggjxkOEyDYHKH_9uIvp8ounyaNejB6f3e_nyee3V7eX79KbD9fvL3c3qSwYC2mu-qLrpBBQFUzJBnMUrJZNJypFZVvUSCshmgJLUG2v4rGGrpS5rFWbQ9cW58n22Hd29uuCPvBJe4ljjId28ZyysmooqyGP6Mt_0L1dXHz9SrUthegBItUcKRmje4c9n52ehDtwCnw1yff8ZJKvJjkwHk3Gyuf3_ZduQnWq-6suArsjgPFDvml03EuNRqLSDmXgyur_DvkNtpu20A</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Buczak-Stec, Elżbieta</creator><creator>Goryński, Paweł</creator><creator>Nitsch-Osuch, Aneta</creator><creator>Kanecki, Krzysztof</creator><creator>Tyszko, Piotr</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TQ</scope><scope>8BJ</scope><scope>DHY</scope><scope>DON</scope><scope>FQK</scope><scope>JBE</scope><scope>7X8</scope></search><sort><creationdate>201711</creationdate><title>The impact of introducing a new hospital financing system (DRGs) in Poland on hospitalisations for atherosclerosis: An interrupted time series analysis (2004–2012)</title><author>Buczak-Stec, Elżbieta ; Goryński, Paweł ; Nitsch-Osuch, Aneta ; Kanecki, Krzysztof ; Tyszko, Piotr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-2df3bbcaa0539dc7e2ea96c7ba5d1c836e15aa73e40d8fdaa760b4c2c6d820b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age differences</topic><topic>Age groups</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atherosclerosis</topic><topic>Atherosclerosis - epidemiology</topic><topic>Data collection</topic><topic>Diagnosis-related groups</topic><topic>Diagnosis-Related Groups - economics</topic><topic>Diagnosis-Related Groups - statistics & numerical data</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Financing</topic><topic>Health administration</topic><topic>Health care reform</topic><topic>Health policy change</topic><topic>Hospitalization</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals</topic><topic>Hospitals, District - statistics & numerical data</topic><topic>Hospitals, Private - statistics & numerical data</topic><topic>Humans</topic><topic>Implementation</topic><topic>Internal medicine</topic><topic>Interrupted time series</topic><topic>Interrupted Time Series Analysis</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Patients</topic><topic>Poland</topic><topic>Regression analysis</topic><topic>Time series</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Buczak-Stec, Elżbieta</creatorcontrib><creatorcontrib>Goryński, Paweł</creatorcontrib><creatorcontrib>Nitsch-Osuch, Aneta</creatorcontrib><creatorcontrib>Kanecki, Krzysztof</creatorcontrib><creatorcontrib>Tyszko, Piotr</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>PAIS Index</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>MEDLINE - Academic</collection><jtitle>Health policy (Amsterdam)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buczak-Stec, Elżbieta</au><au>Goryński, Paweł</au><au>Nitsch-Osuch, Aneta</au><au>Kanecki, Krzysztof</au><au>Tyszko, Piotr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of introducing a new hospital financing system (DRGs) in Poland on hospitalisations for atherosclerosis: An interrupted time series analysis (2004–2012)</atitle><jtitle>Health policy (Amsterdam)</jtitle><addtitle>Health Policy</addtitle><date>2017-11</date><risdate>2017</risdate><volume>121</volume><issue>11</issue><spage>1186</spage><epage>1193</epage><pages>1186-1193</pages><issn>0168-8510</issn><eissn>1872-6054</eissn><abstract>•Hospital payment based on DRGs was introduced in Poland in July 2008.•Following DRGs implementation, a sharp increase in hospitalisations for atherosclerosis was observed.•Non-public hospitals did not exhibit a rapid response to DRGs introduction.•Changes in the hospitalisation rates may be the result of DRGs introduction.•Failure to account for these changes may result in incorrect epidemiological data.
Hospital payment based on diagnosis-related groups (DRGs) was introduced in Poland in July 2008. We evaluate the impact of this policy on the frequency of hospitalisation for atherosclerosis in internal medicine units of district hospitals and non-public hospitals in Poland.
Data were collected between 2004 and 2012 from each district and non-public hospital participating in the General Hospital Morbidity Study (165 hospitals in total). Atherosclerosis was defined using the ICD-10 code I70. Hospitalisation patterns were examined using interrupted time series with segmented regression analysis. Results were compared between public and non-public hospitals and across patient age groups.
The rate of hospitalisation for atherosclerosis rose by 27.05 per 10,000 total hospitalisations immediately following the implementation of DRGs in 2008. It then rose by 2.5 per 10,000 hospitalisations monthly between 2008–2012. The largest changes were observed for patients aged 85+ and 75–84. Rates rose by 117.5 and 54.2 per 10,000 hospitalisations in these two groups respectively following implementation of DRGs. The response to introduction of DRGs was less striking in non-public hospitals than in public hospitals.
Implementation of a DRG-based system in Poland was associated with substantial increases in atherosclerosis hospitalisation rates. Failing to take into account this change in financing and not accounting for long-term trends in hospitalisation rates may result in inaccurate epidemiological data.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>28967491</pmid><doi>10.1016/j.healthpol.2017.09.009</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult Age differences Age groups Aged Aged, 80 and over Atherosclerosis Atherosclerosis - epidemiology Data collection Diagnosis-related groups Diagnosis-Related Groups - economics Diagnosis-Related Groups - statistics & numerical data Epidemiology Female Financing Health administration Health care reform Health policy change Hospitalization Hospitalization - statistics & numerical data Hospitals Hospitals, District - statistics & numerical data Hospitals, Private - statistics & numerical data Humans Implementation Internal medicine Interrupted time series Interrupted Time Series Analysis Male Medical diagnosis Medicine Middle Aged Morbidity Patients Poland Regression analysis Time series |
| title | The impact of introducing a new hospital financing system (DRGs) in Poland on hospitalisations for atherosclerosis: An interrupted time series analysis (2004–2012) |
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