Evaluation of the real applicability of diagnosis related groups for benign prostate surgery

Abstract

Introduction: The treatment of benign surgical hyperplasia includes transurethral resection of the prostate (TURP) and open prostatectomy, which have distinct indications. Diagnosis Related Groups (DRG) is a classification system of patients with similar standards for predicting hospital products and services. However, some DRG codes include several treatment regimens, such as 707 and 708, which include TURP and open prostatectomy. Objective: To compare hospital stay and adverse events for TURP and open prostatectomy. Methods: Crosssectional, retrospective, quantitative study, in which 279 urology patients submitted to TURP or open prostatectomy were selected between 2017 and 2021, classified as code DRG 707 or 708, which refer to major male surgeries of the pelvic region with comorbidities and major male surgeries of the pelvic region without comorbidities, respectively, Patients were divided into two groups, 220 selected for TURP and 59 for open prostatectomy. Results: There was a significant difference in hospital stay (p<0,001): 2.1 (2.0-2.3) days in TURP vs. 3.1 (3.0-4.3) days in open prostatectomy. A significant difference was also observed in the frequency of adverse events (p=0.04): in TURP, the frequency was 7.7% and in prostatectomy it was 22%. There was no significant difference in comorbidities between the two groups. Conclusion: TURP presented minor hospital stay and minor frequency of adverse events when compared to open prostatectomy. We suggest a stratification of DRG codes 707 and 708, so that benign surgeries can be included in different codes.

Keywords

• prostatic hyperplasia
• transurethral resection of prostate
• prostatectomy
• diagnosis-related groups