Early results of pediatric appendicitis after adoption of diagnosis-related group-based payment system in South Korea

Figures & data

Table 1 Patient demographics

Characteristics	FFS group (n=30)	DRG (n=30)	P-value
Mean age (range), years	13.4 (6–18)	12.9 (5–18)	0.68
Sex ratio (M:F)	19:11	18:12	1
Operation method	28 LA, 2 OA	28 LA, 2 OA	1
Operation time (range), minutes	35.2 (20–70)	39.1 (30–60)	0.09
Imaging modality	28 CT, 2 USG	30 CT	0.49
Postoperative diagnosis	26 SA, 4 CA	27 SA, 3 CA
DRG code (n)
G08400	24	25
G08300	3	2
G08301	0	1
G08302	1	0
G08200	2	2

Abbreviations: CA, complicated appendicitis; CT, computed tomography; DRG, diagnosis-related group; F, female; FFS, fee-for-service; LA, laparoscopic appendectomy; M, male; OA, open appendectomy; SA, simple appendicitis; USG, ultrasonography.

Table 2 Quality of health care before and after adoption of the DRG system

	FFS group (n=30)	DRG (n=30)	P-value
Mean hospital stay	3.6 days (3–13 days)	3.5 days (3–8 days)	0.80
Postoperative complications	1 (abscess)	1 (ileus)	1
Readmission	0	0	1

Abbreviations: DRG, diagnosis-related group; FFS, fee-for-service.

Figure 1 Health care expenditures in both groups.

Note: Overall expenditure and self-payment decreased in the DRG.
Abbreviations: DRG, diagnosis-related group; FFS, fee-for-service; HE, health care expenditure; HE-DRG_DRG, HE in DRG group measured by DRG system; HE-DRG_FFS, HE in DRG group measured by FFS system; KRW, Korean Won.

Figure 2 Health care expenditures stratified by the DRG code.

Note: One patient in the FFS group consumed an excessive cost of KRW 5,094,818 due to postoperative complication. Values are given in KRW.
Abbreviations: DRG, diagnosis-related group; FFS, fee-for-service; KRW, Korean Won.

Figure 3 For the DRG patients, calculation by the DRG system yielded more overall expenditure but less self-payment.

Abbreviations: DRG, diagnosis-related group; FFS, fee-for-service; HE, health care expenditure; HE-DRG_DRG, HE in DRG group measured by DRG system; HE-DRG_FFS, HE in DRG group measured by FFS system; KRW, Korean Won.