Abstract

Aim of the study was to compare the ability of the all patients refined diagnosis related groups (APR-DRG) with the centre for medicare and medicaid services diagnosis related groups (CMS-DRG) in predicting multidimensional impairment of elderly patients. Cases discharged from 20 geriatric units were grouped by the CMS-DRG and the APR-DRG. A comprehensive geriatric assessment (CGA) was performed using the activities of daily living (ADL), instrumental activities of daily living (IADL), short portable mental status questionnaire (SPMSQ), comorbidity index rating scale (CIRS), mini nutritional assessment (MNA), geriatric depression scale-short form (GDS-SF) and exton smith scale (ESS). Number of drugs at admission (DPA) and length of stay (LOS) were also recorded. CMS-DRG and APR-DRG relative weights (RW) were used for comparisons. 1273 patients were included. With increasing the APR-DRG-RW, a significant increase in the prevalence of impaired patients was found in ADL, IADL, SPMSQ, CIRS, GDS-SF and ESS. The CMS-DRG-RW subgroups showed a significant difference for MNA and GDS-SF. LOS was significantly different for both APR and CMS DRG. The number of CGA domains in which APR showed a more significant trend in disability when compared to CMS DRG demonstrates that the former was a better predictor of multidimensional impairment.

Key words: All patients refined diagnosis related groups (APR-DRG), centre for medicare and medicaid services diagnosis related groups (CMS-DRG), comprehensive geriatric assessment, elderly.