Impact of DRGS on staffing, workload and budget in Texas hospital laboratories

On October 1, 1983, the federal government implemented a new cost containment program known as the Prospective Payment System (PPS) which relied on a disease classification system, the Diagnostic Related Groups (DRGs), for Medicare reimbursement. Unlike any previous cost containment programs, PPS paid a fixed amount for a particular DRG category regardless of the hospital days or number of diagnostic procedures, PPS was expected to bring about drastic changes in the medical laboratory. In order to examine the impact of DRGs on Texas hospital laboratories seven research questions were developed dealing with staffing, workload, and budget, A survey was mailed to laboratory directors of one hundred randomly selected hospitals in the State of Texas; resulted in a seventy percent response. Data analysis revealed that by 1986 a small, yet statistically significant, decline from the 1982 levels occurred in staffing, workload, and budget. The decline in staffing was accompanied by proportional declines in workload and budget. Hospital size or percentage of income derived from Medicare had no significant influence on the extent of this decline. Even though some improvement was expected in staffing, work load, and budget by 1990, the levels were still expected to be below those of 1982. The participants reported a small increase in the amount of time devoted to quality controls They predicted significant role changes among medical technologists and technicians; technologists were expected to assume supervisory functions while technicians assumed routine functions in the laboratory. Those providing training reported no significant changes in student enrollment from 1982 to 1986. Based on the findings on this study, it was concluded that the reimbursement system based on DRGs has brought about a retardation in staffing, workload, and budget in Texas hospital laboratories without any decrease in the quality of work. By the year 1990 a majority of the laboratory work will be performed by technicians; technologists will be required to assume leadership roles.