Does managed care influence outcome for DRG 483?
Diane M Dewar, PhD, School of Public Health, University at Albany, One University Place, Room 171, Rensselaer, NY 12144, 518-402-0290, ddewar@albany.edu and Jean-Paul Hafner, MD, MPH, Stratton VA Medical Center, New Scotland Avenue, Albany, NY 12203. Patients undergoing mechanical ventilation with tracheostomy have a high mortality rate and consume a significant amount of resources in the Intensive Care Unit. Advanced age and chronic illnesses are highly associated with mortality. Managed care has been somewhat successful in reducing the use of these expensive resources, but whether or not survival is adversely impacted is not known. Discharge abstracts from the Statewide Planning and Research Cooperative System in New York for a population of 33,793 patients discharged under DRG 483 during 1992-1996 were selected for analysis. A multivariate Cox Proportional Hazard analysis was preformed to determine the major determinants of survival, and to determine if managed care participation im
