Costing for long-term care: the development of Scottish health service resource utilization groups as a casemix instrument
| Autor: | I Lennox, D C Kennie, J Urquhart, R G Smith, P S Murdoch |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Aging
medicine.medical_specialty Health Services for the Aged business.industry Shrug General Medicine Variance (accounting) Relative Value Scales Long-Term Care Unit (housing) Long-term care Inter-rater reliability Resource (project management) Scotland Nursing Family medicine Health care medicine Humans Hospital Costs Geriatrics and Gerontology business Activity-based costing Aged |
| Zdroj: | Age and Ageing. 28:187-192 |
| ISSN: | 1468-2834 |
| DOI: | 10.1093/ageing/28.2.187 |
| Popis: | OBJECTIVE to create a casemix measure with a limited number of categories which discriminate in terms of resource use and will assist in the development of a currency for contracting for the provision of health care. DESIGN nursing staff completed a questionnaire providing clinical data and also gave estimates of relative patient resource use; ward-based costs were collected from appropriate unit managers. SETTING National Health Service continuing-care wards in 50 Scottish hospitals. SUBJECTS 2783 long-stay patients aged 65 years and over. RESULTS inter-rater reliability was assessed using 1402 patients; percentage agreement between raters for individual variables varied from 68% for feeding to 97% for clinically complex treatments. Nursing costs gave 62% agreement given categories of high, medium and low. The Scottish health service resource utilization groups (SHRUG) measure was developed using 606 cases, and 67% consistency was achieved for the five categories. The relative weights for the SHRUG categories ranged from 0.56 to 1.41. The five categories explain 35% of variance in costs. CONCLUSIONS the five SHRUG casemix categories show good discrimination in terms of costs. The SHRUG measure compares favourably with diagnosis-related groups in the acute sector and with other casemix instruments for long-term care previously piloted in the UK. SHRUG is a useful measurement instrument in assessing the resource needs of elderly people in long-term care. |
| Databáze: | OpenAIRE |
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