Trauma centers and DRGs--inherent conflict?

A study of 69 patients hospitalized among 601 consecutive patients treated for injuries involving woodworking, construction, and related activities showed that average cost of care and average DRG reimbursement rose with increasing severity, with cost rising at a much faster rate than reimbursement. Overall, however, for patients from both primary and tertiary care patient sheds, actual hospital billings closely approximated DRG schedules. This contrasts markedly with a New Jersey study limited to ICU patients which found substantial losses under DRG reimbursement for even the least severe cases and increasing losses at each higher severity level. The different results appear to reflect dissimilarities of sampling.