Table 5.

Comparison of Classification of Normal Newborns in Three DRG Systems

Normal Newborns in Each DRG Classification SystemNumber of CasesPercent of All NeonatesAverage LOSAverage CostCoefficient Variation Cost
V 12.0 Medicare DRGs:
 DRG 391, Normal newborn316 73865.3%1.7$509.48
V 12.0 AP-DRGs:
 AP-DRG 620, Birth weight 2000–2499 g   90811.9%2.9$11921.23
 AP-DRG 629, Birth weight >2499 g408 20984.1%1.8$562.61
Total, Normal newborns417 29086.0%1.8$576N/A
V 12.0 APR-DRGs:
 APR-DRG 657.1 Birth weight 2000–2499 g   4020.8%2.1$647.63
 APR-DRG 677.1 Birth weight >2500 g375 91077.5%1.8$516.48
Total, Normal newborns379 93078.3%1.8$517N/A
  • Costs include hospital operating and capital costs, exclusive of graduate medical education costs, adjusted by HCFA area wage index.

    Analytic outliers are removed from the above statistics. High-cost outliers are defined as the highest 1% of patients in each DRG in each DRG system and low-cost outliers are defined as the lowest ½% of patients in each DRG in each DRG system. Thus, approximately 7400 of the database's 492 558 neonates are removed from the above statistics.

    Some of the more expensive neonates classified by the AP-DRGs as normal newborns are classified by the APR-DRGs into an intermediate category for other problems through its severity subclasses. The cost for these neonates is intermediate to that of normal newborns and those with significant problems. Not shown above, the statistics for these neonates are: APR-DRG 677.2, birth weight >2500 g, other problem: 32 037 cases, 2.6 ALOS, $1082 cost, .86 CV; and APR-DRG 677.3, birth weight >2500 g, other problem (multiple): 4422 cases, 4.4 ALOS, $2460 cost, .90 CV.

    Coefficient of variation is the standard deviation divided by the arithmetic mean.

    ALOS is average length of stay.