Assessing the effects of the Medicare Prospective Payment System on the demand for VA inpatient services: an examination of transfers and discharges of problem patients.

An examination of patient data from three medical districts that vary in urban/rural composition and in their proportion of proprietary hospitals was undertaken to determine if high-cost patients whose illnesses place them in "problem" DRGs (diagnosis-related groups identified as "problems" through interviews with private hospital administrators and from information published by the Wisconsin Hospital Association) are being shifted from …