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International Journal for Quality in Health Care 15:433-440 (2003)
© 2003 International Society for Quality in Health Care

Patient-reported quality of life before, compared with after a DRG intervention

Birgitta Ljunggren and Per-Olow Sjödén

Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden

Objective. To evaluate the effects of the introduction of a payment system based on Diagnosis-Related Groups (DRG) on orthopedic patients’ perceptions of quality of life after discharge.

Design. A prospective longitudinal study performed between 1992 and 1996.

Setting. Two surgical clinics in the County of Gävleborg, Sweden.

Study participants. The selection of patients was defined by surgical treatments/diagnoses, and by geographical area. Out of the 40 consecutively recruited patients per year from each hospital, >85% (n = 145 + 140 = 285) completed a questionnaire 1 week post-discharge, and >75% (n = 128 + 127 = 255) did so at a 6-week follow-up.

Main outcome measure. The Swedish Health-Related Quality of Life Survey (SWED-QUAL) was used to assess quality of life. Straight factoral analyses of variance (ANOVAs) were performed to compare years of assessment in the same hospital/district.

Results. The results demonstrated no pattern of significant pre–post differences in patient-reported quality of life. In all years, most quality of life ratings were lower at 1 week compared with 6 weeks after discharge. These differences were probably the consequence of recently undergone surgery.

Conclusion. The overall conclusion is that changes implemented in health care, including the DRGs, had no demonstrable impact on patient ratings of quality of life.

Keywords: Diagnosis-Related Groups, orthopedic patients, patient satisfaction, quality of care, quality of life

Address reprint requests to Birgitta Ljunggren, Department of Caring Science and Sociology, University of Gävle, S-80176 Gävle, Sweden. E-mail: birgitta.ljunggren{at}hig.se

Accepted for publication June 3, 2003.


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