Using Existing Case-Mix Methods to Fund Trauma Cases
| Autor: | Gino Picciano, Julia Monakova, Yuriy Chechulin, Charles Botz, Antoni Basinski, Irene Blais |
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| Rok vydání: | 2010 |
| Předmět: |
Ontario
Financing Government Actuarial science National Health Programs Leadership and Management business.industry Strategy and Management Health Policy Poison control Payment system Human factors and ergonomics General Medicine Regression Weighting Case mix index Injury prevention Humans Wounds and Injuries Medicine Injury Severity Score business Diagnosis-Related Groups health care economics and organizations |
| Zdroj: | Journal of Healthcare Management. 55:51-64 |
| ISSN: | 1096-9012 |
| DOI: | 10.1097/00115514-201001000-00010 |
| Popis: | Policymakers frequently face the need to increase funding in isolated and frequently heterogeneous (clinically and in terms of resource consumption) patient subpopulations. This article presents a methodologic solution for testing the appropriateness of using existing grouping and weighting methodologies for funding subsets of patients in the scenario where a case-mix approach is preferable to a flat-rate based payment system. Using as an example the subpopulation of trauma cases of Ontario lead trauma hospitals, the statistical techniques of linear and nonlinear regression models, regression trees, and spline models were applied to examine the fit of the existing case-mix groups and reference weights for the trauma cases. The analyses demonstrated that for funding Ontario trauma cases, the existing case-mix systems can form the basis for rational and equitable hospital funding, decreasing the need to develop a different grouper for this subset of patients. This study confirmed that Injury Severity Score is a poor predictor of costs for trauma patients. Although our analysis used the Canadian case-mix classification system and cost weights, the demonstrated concept of using existing case-mix systems to develop funding rates for specific subsets of patient populations may be applicable internationally. |
| Databáze: | OpenAIRE |
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