Development of a casemix classification to predict costs of home care in the Netherlands: a study protocol
| Autor: | Dirk Ruwaard, Anne van den Bulck, Gertjan S. Verhoeven, Silke F. Metzelthin, Misja Mikkers, Jaap E. Stam, Lieuwe Christiaan van der Weij, Maud H. de Korte, Arianne M. J. Elissen |
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| Přispěvatelé: | Health Services Research, RS: CAPHRI - R2 - Creating Value-Based Health Care, RS: CAPHRI - R1 - Ageing and Long-Term Care, RS: Academische Werkplaats Ouderenzorg |
| Rok vydání: | 2020 |
| Předmět: |
media_common.quotation_subject
statistics & research methods Payment system Care provision organisation of health services Protocol Medicine Humans health economics Health policy Diagnosis-Related Groups media_common Accreditation Netherlands Protocol (science) Health economics Actuarial science business.industry Health Policy Fee-for-Service Plans General Medicine Health Care Costs Payment Home Care Services MODEL Cross-Sectional Studies INSTRUMENTAL ACTIVITIES business SYSTEM Cohort study Forecasting |
| Zdroj: | BMJ Open BMJ Open, 10(2):035683. BMJ Publishing Group BMJ Open, Vol 10, Iss 2 (2020) |
| ISSN: | 2044-6055 |
| Popis: | IntroductionCompared with fee-for-service systems, prospective payment based on casemix classification is thought to promote more efficient, needs-based care provision. We aim to develop a casemix classification to predict the costs of home care in the Netherlands.Methods and analysisThe research is designed as a multicentre, cross-sectional cohort study using quantitative methods to identify the relative cost predictors of home care and combine these into a casemix classification, based on individual episodes of care. The dependent variable in the analyses is the cost of home care utilisation, which is operationalised through various measures of formal and informal care, weighted by the relative wage rates of staff categories. As independent variables, we will use data from a recently developed Casemix Short-Form questionnaire, combined with client information from participating home care providers’ (nursing) classification systems and data on demographics and care category (ie, a classification mandated by health insurers). Cost predictors are identified using random forest variable importance measures, and then used to build regression tree models. The casemix classification will consist of the leaves of the (pruned) regression tree. Internal validation is addressed by using cross-validation at various stages of the modelling pathways. The Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis statement was used to prepare this study protocol.Ethics and disseminationThe study was classified by an accredited Medical Research Ethics Committee as not subject to the Dutch Medical Research Involving Human Subjects Act. Findings are expected in 2020 and will serve as input for the development of a new payment system for home care in the Netherlands, to be implemented at the discretion of the Dutch Ministry of Health, Welfare and Sports. The results will also be published in peer-reviewed publications and policy briefs, and presented at (inter)national conferences. |
| Databáze: | OpenAIRE |
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