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Title
Reliability and validity in hospital case-mix measurement.
First Author
Pettengill, Julian
Date of Pub
1982 Dec
Pages
101-128
Volume
4
Issue
2
Other Authors
Vertrees, James C
Abstract
There is widespread interest in the development of a measure of hospital output. This paper describes the problem of measuring the expected cost of the mix of inpatient cases treated in a hospital (hospital case-mix) and a general approach to its solution. The solution is based on a set of homogeneous groups of patients, defined by a patient classification system, and a set of estimated relative cost weights corresponding to the patient categories. This approach is applied to develop a summary measure of the expected relative costliness of the mix of Medicare patients treated in 5,576 participating hospitals. The Medicare case-mix index is evaluated by estimating a hospital average cost function. This provides a direct test of the hypothesis that the relationship between Medicare case-mix and Medicare cost per case is proportional. The cost function analysis also provides a means of simulating the effects of classification error on our estimate of this relationship. Our results indicate that this general approach to measuring hospital case-mix provides a valid and robust measure of the expected cost of a hospital's case-mix.
Abstract Continued
N/A
MeSH
Costs and Cost Analysis/methods : Diagnosis-Related Groups : Abstracting and Indexing : Diagnostic Errors : Medicare/economics : Models, Theoretical : Regression Analysis : United States
NTIS Number
PB83-149815