This research study assessed the impact of the application of the DRG procedure on (1) health care access for individuals whose health care is funded all or in part by the federal government, (2) the quality of health care received by individuals whose health care is funded all or in part by the federal government, and (3) health care costs associated with care delivered to those individuals whose care is funded all or in part by the federal government. In this chapter, literature is reviewed in relation to the problem area investigated.
The impacts of DRGs on patient care are not addressed in this literature review, as those impacts provided the focus for the research performed for this study. Rather, this literature focuses policy criteria and development affecting health care, and medical economics and hospital financial management. The former are related to the development and application of the DRG procedure, while the latter are related to the non patient impacts of the application of the DRG procedure. Lastly, a related study is reviewed, which potentially holds some lessons for the application of the DRG procedure.
Policy Criteria and Development In modern American society, prospects for the health of individuals are ". . . determined by public policy, by those decisions which shape contemporary environments . . . " (Milio, 1981, p. 3). Within this context, health, is ". . . not a 'state' to be captured and dealt with; nor is it some achievement to be attained with finality. It is rather the response of people to their environments . . ." (Milio, 1981, p. 3).
Health policy development at the national level is required, because the factors affecting individual health are, typically, pervasive in American society. Thus, the development of acceptable levels of public health within a large and complex society such as that of the United States
. . . requires and interpretation of the nature of today's health...