Case mix, quality, and cost relationships in Colorado nursing homes.
Schlenker, Robert E
Date of Pub
Shaughnessy, Peter W
The analyses reported in this article assessed the cost, case mix, and quality interrelationships among Colorado nursing homes.
A unique set of patient-level data was collected specifically to measure case mix and quality. Case mix was found to be strongly
associated with cost, accounting for up to 45 percent of the variation in cost per patient day. The relationship between quality
and cost was weaker; quality variables accounted for only about 10 percent of the cost per day variation. Case mix was also
associated with several facility characteristics found to be significant in other cost studies, suggesting that such facility
characteristics serve as partial proxy measures for case mix. The cost-case mix relationships appear to be strong enough to
justify incorporating case mix directly in nursing home reimbursement systems. In contrast, the weaker cost-quality association
implies that it may not (yet) be appropriate to incorporate quality directly in reimbursement.
Costs and Cost Analysis : Diagnosis-Related Groups : Colorado : Medicaid : Medicare : Nursing Homes/economics : Quality of
Health Care/economics : Regression Analysis