Relative intensity measures: pricing the inpatient nursing services under diagnosis-related group prospective hospital payment.
Caterinicchio, Russell P
Date of Pub
A sample survey (N = 2660) was conducted at eight acute care hospitals in New Jersey during an 11-month period between 1979
and 1981 in order to develop a client-focused, case-mix sensitive measure of resource use for the allocation of inpatient
general nursing costs. Using general linear modeling techniques, the direct and indirect effects of age, length of stay, multiple
diagnoses, multiple procedures, the ratio of special care unit days to length of stay, and the effects of the presence of
surgery, admission status, discharge status, and membership in Major Diagnostic Categories on indexed total units of nursing
service were explored. The results of the analysis suggested that length of stay is the most significant predictor of indexed
nursing units of service regardless of age and the complexity of the medical problem when case-mix is controlled through the
assignment of cases to 13 nursing services isoresource clusters. The methodology yields an empirically derived patient-specific,
case-mix adjusted length of stay statistic which can be used to apportion nursing costs by the case. The approach permits
the estimation of nursing units of service which reflect the relative amount of nursing inputs and corresponding costs of
direct in any given hospital.
Costs and Cost Analysis : Diagnosis-Related Groups : Cost Allocation : Factor Analysis, Statistical : Length of Stay/economics
: New Jersey : Nursing Service, Hospital/economics : Time and Motion Studies