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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