- Title
- Toward a prospective payment system for ambulatory surgery.
- First Author
- Lion, Joanna
- Date of Pub
- 1990 Spring
- Pages
- 79-86
- Volume
- 11
- Issue
- 3
- Other Authors
- Collard, Ann F; Malbon, Alan; Mowschenson, Peter; Vertrees, James C
- Abstract
- In this article, ambulatory surgery among the aged Medicare population in 1985 is examined. Total hospital facility charges for ambulatory surgery in that year were estimated at $1.8 billion, with about one-half of that amount involving cataract surgery. The possibility of using diagnosis-related groups for a prospective payment system for ambulatory surgery was examined and was rejected for two reasons: (1) about 20 percent of the dollar volume of hospital-based ambulatory surgery fell into medical diagnosis-related groups and (2) the ratio of inpatient diagnosis-related group weight to outpatient billed charges for the ambulatory procedures falling into a given diagnosis-related group varied more than tenfold, making diagnosis-related group weights impossible to use in a consistent manner. A newly developed version of ambulatory visit groups and the even newer ambulatory patient groups were then considered as an alternative for a prospective payment system. These are briefly described.
- Abstract Continued
- N/A
- MeSH
- Aged : Ambulatory Surgical Procedures/economics : Data Collection : Diagnosis-Related Groups/economics/statistics & numerical data : Evaluation Studies : Human : Medicare/organization & administration : Prospective Payment System/organization & administration : Rate Setting and Review/methods : Support, U.S. Gov't, Non-P.H.S. : United States
- NTIS Number
- PB90-258153
