Effect of Diagnosis Related Groups on Malnourished Patients With Head and Neck Cancer

Abstract

Malnourished patients with cancer of the head and neck may be adversely affected by the introduction of prospective payment according to diagnosis related groups (DRGs), a recent study shows. Bernard S. Linn, MD, and David S. Robinson, MD, compared 59 male patients with cancer of the head and neck admitted for massive resections before the introduction of DRGs with 61 similar patients admitted after the introduction of DRGs, and classified these patients as malnourished or well nourished. The results of their study, published in JAMA (1988;260:514-518), showed that in malnourished patients, complication scores were over two times higher after the introduction of DRGs. The authors point out that currently, under the prospective payment system, there is no additional allowance for a diagnosis of malnutrition. Their primary findings were that, after the introduction of DRGs, (1) patients have shorter lengths of stay before surgery, (2) patients are more malnourished before