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Correspondence
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Volume 330:578-579 February 24, 1994 Number 8
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The Prospective Payment System and Discharge Diagnoses for Coronary Heart Disease

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 by Assaf, A. R.
To the Editor: The article by Assaf et al. (Sept. 23 issue)1 discusses many possible theories about the effect of prospective payment systems and diagnosis-related groups (DRGs) in leading to more expensive coding of discharge diagnoses, so that payments to hospitals are increased. The article does not clarify whether hospitals are making more precise diagnoses or whether there is a behavioral bias favoring acute conditions.

What requires serious consideration, however, is the improvement in the knowledge base available to physicians from 1980 through 1988, the time of this study. During these years the diagnosis of unstable angina was extensively evaluated, . . . [Full Text of this Article]




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