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Diagnosis Related Group (DRG) payment system has been applied to 5 diagnosis group (Lens procedure, Tonsilectomy and/or Adenoidectomy, Cesarean section, Vaginal delivery) at Kang-Nam St. Mary´s hospital since Feb. 1998. To analyze the medication use and its effect, of this system, we reviewed the medical records of total 586 patients who had been hospitalized with the above diagnosis during Aug. 1997, the Doings-Based Group (DBG) and Aug. 1998, the DRG. We compared the total cost, average length of hospital stay, cost of medications including the antibiotics, and the therapeutic effects by defining the cause of prolonged length of hospital stay between the two groups. As a result, the total cost was decreased in DRG mainly by shortening the length of hospital stay. The total medication and the antibiotic costs were decreased only in the Cesarean section and in vaginal delivery group of the DRG. But the ratio of the antibiotic cost to the total medication cost was decreased in all DRG. We found no differences of the therapeutic effects in both groups and no case of motality nor re-operation. In conclusion, the total medication cost were increased or decreased in the DRG comparing with the DBG without therapeutic differences. But in pharmacoeconomic point of view, we should try to make a medication guideline since there has been a tendency to use more recent and expensive medications. For this purpose active participation of the pharmacist in a critical pathway team is imperative for the patients.
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