{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:16:33Z","timestamp":1787760993954,"version":"build-2784847793"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:00:00Z","timestamp":1610755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:00:00Z","timestamp":1610755200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:00:00Z","timestamp":1610755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Laparoscopic cholecystectomy (LC) is a common procedure for cholelithiasis paid by diagnostic\u2010related groups (DRGs) systems. However, acute cholecystitis (AC) patients usually have heterogeneous conditions that compromise the successful implementation of DRGs. We evaluated the quality\/efficiency of treating AC patients under the DRG system in Taiwan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All AC patients who underwent LC between October 2015 and December 2016 were included. Patient demographics, treatment outcomes, and financial results were analyzed. Patients were reimbursed by one of the two DRG schemes based on their comorbidities\/complications (CC): DRG\u20101, LC without CC; and DRG\u20102, LC with CC. Hospitals were reimbursed the costs incurred if they were below the lower threshold (balanced sector); with the outlier threshold if costs were between the lower and outlier thresholds (profitable sector); and with the outlier threshold plus 80% of the exceeding cost if costs were higher than the outlier threshold (profit\u2010losing sector).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 246 patients, 114 were paid by DRG\u20101, and 132 were by DRG\u20102. In total, 195 of 246 patients underwent LC within 1\u00a0day after admission, and patients with mild AC had shorter hospital stays than those with moderate or severe AC. The complication rate was 7.3% with only one mortality. In total, 92.1% of patients in DRG\u20101 and 90.9% of patients in DRG\u20102 were profitable. The average margin per patient was 11,032 TWD for DRG\u20101 and 24,993 TWD for DRG\u20102.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DRGs can be well adopted for acute care surgery, and hospitals can still provide satisfactory services without losing profit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-020-05904-5","type":"journal-article","created":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T15:02:30Z","timestamp":1610809350000},"page":"1080-1087","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Diagnosis\u2010Related Group (DRG)\u2010Based Prospective Hospital Payment System can be well adopted for Acute Care Surgery: Taiwanese Experience with Acute Cholecystitis"],"prefix":"10.1002","volume":"45","author":[{"given":"Yu\u2010Tung","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Trauma and Emergency Surgery Linkou Branch of Chang Gung Memorial Hospital No. 5, Fuxing St, Guishan Dist 33305 Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Ning","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of General Surgery Linkou Branch of Chang Gung Memorial Hospital No. 5, Fuxing St, Guishan Dist 33305 Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Tung","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Linkou Branch of Chang Gung Memorial Hospital No. 5, Fuxing St, Guishan Dist 33305 Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Yuan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Linkou Branch of Chang Gung Memorial Hospital No. 5, Fuxing St, Guishan Dist 33305 Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Hung","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Linkou Branch of Chang Gung Memorial Hospital No. 5, Fuxing St, Guishan Dist 33305 Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2021-9555","authenticated-orcid":false,"given":"Chi\u2010Hsun","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Linkou Branch of Chang Gung Memorial Hospital No. 5, Fuxing St, Guishan Dist 33305 Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3197"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QMH.0b013e3181ccbcc3"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2014.121"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.2836"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010011\u20100877\u20105"},{"key":"e_1_2_6_7_1","volume-title":"Physician profiling and risk adjustment","author":"Goldfield N","year":"1996"},{"key":"e_1_2_6_8_1","first-page":"175","article-title":"Using delta\/DRG diagrams and decision tree analysis to select a cost\u2010effective surgery for cholecystitis","volume":"1","author":"Weiland DE","year":"1997","journal-title":"JSLS"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","unstructured":"GurusamyKS DavidsonC GluudCet al. Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis.Cochrane Database Syst Rev(2013)10.1002\/14651858.CD005440.pub3243469577388923","DOI":"10.1002\/14651858.CD005440.pub3"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072\u20107515(03)00338\u20107"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2015.06.012"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010148\u20104\u2010200802190\u201000004"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072\u20107515(01)00870\u20105"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.515"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002770"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.115931"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2016.04.018"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2017.09.009"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2012.03.021"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4458"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2019.0042"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534\u2010012\u20100536\u20104"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534\u2010012\u20100563\u20101"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003835"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010006\u20109006\u2010x"},{"key":"e_1_2_6_26_1","first-page":"583","article-title":"Global surgical package reimbursement and the acute care surgeon: a threat to optimal care","volume":"70","author":"Schneider EB","year":"2011","journal-title":"J Trauma"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010015\u20104481\u20106"},{"key":"e_1_2_6_28_1","unstructured":"SibiaUS TurcotteJJ KluneJRet al. Are we ready for bundled payments for major bowel surgery?.Surg Endosc(2019)10.1007\/s00464\u2010019\u201007287\u2010831823048"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/2151459320916947"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2010.100044"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1098\u20103015(10)72948\u2010X"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2016.12.006"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010148\u20104\u2010200802190\u201000011"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.11.020"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.1152"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.1150"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.1149"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2011.07.001"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05904-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-020-05904-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05904-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-020-05904-5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T12:49:25Z","timestamp":1704631765000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-020-05904-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,16]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1007\/s00268-020-05904-5"],"URL":"https:\/\/doi.org\/10.1007\/s00268-020-05904-5","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-39863\/v1","asserted-by":"object"}]},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,16]]},"assertion":[{"value":"5 December 2020","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This is a retrospective chart-review study, no identifying information of any individual is included.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}}]}}