Marketing and health care implications of hospitals adapting to DRG reimbursement for Medicare clients.

The mounting financial pressures placed on acute care facilities have resulted in many closings and mergers. They have impacted patient services and other traditional areas of hospital concern. The adoption in 1983 of the Prospective Payment System of reimbursement for Medicare clients has forced increased scrutiny by hospitals of length of stay. This study reviewed the pattern of length of stay (LOS) of all 553 Medicare clients referred for assistance with discharge planning through utilization of home care coordination in a midwestern, 150-bed, acute care hospital in 1989. This descriptive, retrospective study anonymously compiled basic demographic data of all such clients in addition to DRG, LOS, and time of initiation of discharge planning activities by the Home Care Coordinator (HCC). One finding of the correlational statistical analyses showed that as the number of days from the clients' admission to HCC contact increased overall LOS increased. Strong implications exist regarding nursing involvement with discharge planning. Identifying needs and making prompt referrals by members of the health care team can provide positive outcomes for clients and the hospital. Impact on the image and reputation of the hospital from early intervention for discharge planning caused by DRG reimbursement clearly pose marketing problems. This paper identifies areas in which appropriate market opportunities may be discovered and addressed as the hospital makes necessary adaptations to DRG reimbursement.