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The study identified hospital utilization patterns by diagnosis-related group (DRG) produced by mastectomies for malignancy in Sacramento, California, and Syracuse, New York, for the years 1981-1984. A total of 3,449 discharges were included. Total and subtotal mastectomy discharges per capita increased in both areas. The proportion of mastectomy discharges attributed to total mastectomies increased in Sacramento and decreased in Syracuse. Mean stays for mastectomy DRGs declined by 13.72 to 56.38%. In 1984 mean stays ranged from 4.79 to 7.49 days for total mastectomies and 1.88 to 5.44 days for subtotal mastectomies. A major problem identified by the study was the lack of DRG sensitivity to differences in types of procedures. Under DRGs, radical and simple mastectomies are combined in one type of category, while subtotal mastectomies, quadrant resections, and breast biopsies are combined in another.
Bredenberg et al. (Fri,) studied this question.