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The study reviewed 7,050 Medicare patient discharges from 239 hospitals between October 1984 and March 1985, defining poor quality care as substandard medical care failing to meet recognized professional standards.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/national-drg-validation-study-quality-of-patient-care-in-hospitals/322675/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/national-drg-validation-study-quality-of-patient-care-in-hospitals/322675.png","ImageObject",300,407,{"name":92,"@type":93},"Stanford","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-26","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the purpose of this inspection of hospital care quality?","Question",{"text":112,"@type":113},"It analyzed how poor quality care occurred under Medicare’s prospective payment system, including frequency across sampled hospitals, variation by hospital type, and patient characteristics linked to poor quality care.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was poor quality care identified in the study?",{"text":117,"@type":113},"Board-certified physicians reviewed a random sample of Medicare discharges and defined poor quality care as substandard medical care that clearly failed to meet professionally recognized standards.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the major findings on the prevalence and impact of poor quality care?",{"text":121,"@type":113},"The study found 6.6% of sampled patients received poor quality care, and patients with poor quality care were three times more likely to die. Projected nationally, HCFA paid hospitals about $1.2 billion in Fiscal Year 1985 for cases with quality of care problems.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},322675,1790445272,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336477552062,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","# NATIONAL DRG VALIDATION STUDYQUALITY OF PATIENT CARE IN HOSPITALS\n\nOFFICE OF INSPECTOR GENERALOFFICE.QF ANALYSIS AND INSPECTIONS  \nKathy L.AdmireLeonard CzajkaRuth E.CarlsonWm.Mark KrushatDavid Hsia  \n## OFFICE OF INSPECTOR GENERAL\n\nThe mission of the Office of Inspector General(OIG)is to promote the efficiency,effective-ness and integrity of programs in the United States Department of Health and Human Services(HHS).It does this by developing methods to detect and prevent fraud,waste and abuse.Cre-ated by statute in 1976,the Inspector General keeps both the Secretary and the Congress fullyand currently informed about programs or management problems and recommends correctiveaction.The OIG performs its mission by conducting audits,investigations and inspectionswith approximately 1,200 staff strategically located around the country.  \n## OFFICE OF ANALYSIS AND INSPECTIONS\n\nThis report is produced by the Office of Analysis and Inspections(OAD,one of the threemajor offices within the OIG.The other two are the Office of Audit and the Office of Investi-gations.The OAI conducts inspections which are,typically,short-term studies designed to de-termine program effectiveness,efficiency and vulnerability to fraud or abuse.  \nEntitled “National DRG Validation Study,Quality of Patient Care in Hospitals,”this studywas conducted to analyze and profile the characteristics of patients who received poor qualitycare in hospitals.  \nThe report was prepared under the direction of Kaye D.Kidwell,Regional Inspector General,and Paul A.Gottlober,Deputy Regional Inspector General,Region IX,Office of Analysis andInspections.Participating in this project were the following people:  \nProject DirectorSenior AnalystProgram Assistant  \nMathematical Statistician,HeadquartersMedical Officer,Headquarters  \n# NATIONAL DRG VALIDATION STUDYQUALITY OF PATIENT CARE IN HOSPITALS\n\nRICHARDP.KUSSEROWINSPECTOR GENERAL  \n## EXECUTIVE SUMMARY\n\nPURPOSE  \nThis inspection analyzed the quality of patient care in hospitals under the prospective paymentsystem(PPS)based upon the(a)extent to which poor quality care occurred in a randomsample of hospitals,(b)extent to which poor quality care varied in different types of hospitalsand(c)characteristics of patients who received poor quality care.The report is one of a seriesin the National Diagnosis Related Group Validation Study undertaken by the Office ofInspector General(OIG).  \n## BACKGROUND\n\nEffective October 1983,Congress mandated a change in Medicare payments to hospitals froma cost-based retrospective reimbursement system to a prospective payment system.UnderPPS,hospitals currently receive a fixed payment based upon 1 of 475 diagnosis related groups(DRGs)for each Medicare patient discharge,regardless of the services provided or the lengthof stay.Hospitals retain a profit when patient care costs less than the DRG payment,but mustabsorb losses when costs exceed the DRG.The intent of PPS was to curb rapidly escalatingincreases in Medicare costs for acute inpatient care by giving hospitals an incentive to reducelengths of stay and eliminate unnecessary services without compromising the quality ofpatient care.This issue was included in the National DRG Validation Study to determine theprevalence of poor quality care under PPS.Since there are no comparable data on the qualityof care in hospitals prior to the implementation of PPS,we cannot infer a causal effectbetween PPS and poor quality care.  \nUnder contract to the OIG,board-certified physicians with extensive experience in peerreview identified cases of poor quality care based on an analysis of a random sample of 7,050Medicare patients discharged from 239 hospitals between October 1984 and March 1985.Reviewers defined poor quality care as substandard medical care clearly failing to meetprofessionally recognized standards under any circumstances in any locale.  \nBoth the utilization and quality control peer review organizations(PROs)and the SuperPRO(the contractor which assists ","cbCaic8Nuq9lgaQu","https://ap.wps.com/l/cbCaic8Nuq9lgaQu","pdf",3375870,56,"English","# Executive Summary\n## Purpose\n# Background\n# Major Findings","[{\"question\":\"What was the purpose of this inspection of hospital care quality?\",\"answer\":\"It analyzed how poor quality care occurred under Medicare’s prospective payment system, including frequency across sampled hospitals, variation by hospital type, and patient characteristics linked to poor quality care.\"},{\"question\":\"How was poor quality care identified in the study?\",\"answer\":\"Board-certified physicians reviewed a random sample of Medicare discharges and defined poor quality care as substandard medical care that clearly failed to meet professionally recognized standards.\"},{\"question\":\"What were the major findings on the prevalence and impact of poor quality care?\",\"answer\":\"The study found 6.6% of sampled patients received poor quality care, and patients with poor quality care were three times more likely to die. Projected nationally, HCFA paid hospitals about $1.2 billion in Fiscal Year 1985 for cases with quality of care problems.\"}]","National DRG Validation Study - Quality of Patient Care in Hospitals | PDF",1789963285,141]