Abstract

NORONHA, Marina Ferreira de; PORTELA, Margareth Crisóstomo  and  LEBRAO, Maria Lúcia. Potential uses of AP-DRG to describe the health care profile in hospital units. Cad. Saúde Pública [online]. 2004, vol.20, suppl.2, pp. S242-S255. ISSN 0102-311X.  http://dx.doi.org/10.1590/S0102-311X2004000800019.

The All Patient Diagnosis Related Groups (AP-DRG) provide a classification system for general hospital inpatients, aggregating hospitalizations based on resource use and clinical criteria. The different versions of the AP-DRG have been applied to inpatient care management and reimbursement. This paper aimed to describe the classification and explore the potential for generating information on inpatient care management based on data from the Ribeirão Preto region (São Paulo State, Brazil) in 1997, including public, private, and charity hospitals. We compared average length of stay related to DRGs in the Ribeirão Preto region and the United States. Using the relative cost weights of the AP-DRGs constructed for New York State, we verified the profile of inpatient care provided by 30 hospitals in the Ribeirão Preto region, and reimbursement for hospital care provided to patients referred from other municipalities and covered by the Unified National Health System (SUS). Our findings indicate the applicability of the classification to inform the decision-making process on inpatient care regionalization and organization in levels of complexity, as well as for improvement of inpatient care monitoring and reimbursement.

Keywords : Health Service; Health Resources; Residence Time; Quality Management.