VARIATION IN INPATIENT COST & NET CORPORATE VALUE BY DRG

住院费用的变化

• 批准号: 3371759
• 负责人: JOHN B SILVERS
• 金额: $ 24.01万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-02-01 至 1992-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3371759
• 关键词: computer data analysis; diagnosis quality /standard; health care cost /financing; health care service evaluation; health economics; health insurance; hospital patient care; human subject; occupational health /safety; occupations; socioeconomics

In a period of rapid change in heath care delivery, both managers and policy makers are sorely lacking evidence as to the impact of their actions on outcomes that can be objectively measured and valued. This project proposes to provide an important new gauge of the relationship between inpatient hospital resources and net value received, using the unique perspective of the employer/group purchaser. The large company, a portion of whose data on 350,000 employees will be studied, is both paying for direct heath care services (input side) and absorbing the indirect compensation and productivity costs of lost work time (output side). For the firm decrease in days or dollars of hospitalization for an illness may be offset by the incremental effect of a less rapid return to work. Alternatively, the effect of direct heath care cost containment action may be a faster recovery due to the avoidance of hospital induced complications. This research will provide empirical data by major DRG, among geographical areas and across different industries served by this firm, regarding the tradeoff between direct health care cost and its indirect effect on corporate value. These results also will be useful as indicators of the general effectiveness of the health system regarding other population segments. The methodology will utilize multiple regression to estimate coefficients of input (hospital days and payments) and a number of covariates (job classification, sex, age,probability of termination, and prior years utilization as an indicator of health status) and other dummy control variable (industry, location). These will be examined for significance and differences among subgroups. MANOVA also will be used to test the significance of such differences, and the importance of interaction effects. Aggregation techniques using both parametric and nonparametric transformation, will be used to control for differences across DRGs and thereby permit larger sample sizes for testing hypotheses. The end result will be specific information by critical sub areas of the system on the effectiveness of marginal heath care expenditures. Areas for attention in both policy and management will be highlighted.

在医疗保健服务快速变化的时期，经理和 政策制定者严重缺乏他们行动的影响的证据 关于可以客观衡量和评价的结果。这个项目 建议提供一个重要的新标准来衡量两国之间的关系 住院医院资源和收到的净值，使用唯一 雇主/团购商的观点。大公司，一部分 将对其35万名员工的数据进行研究，这两家公司都在为 直接保健服务(投入方)和吸收间接的 损失工作时间的补偿和生产率成本(产出方面)。为 因病住院天数或住院费用的稳步减少可能 被较慢的重返工作岗位的递增效应所抵消。 或者，直接卫生保健成本控制行动的效果可以 由于避免了住院诱导，恢复得更快 并发症。 这项研究将按主要DRG提供经验数据，包括 该公司所服务的领域和不同行业，关于 直接医疗费用与其间接影响之间的权衡 企业价值。这些结果也将有助于作为 卫生系统对其他人口的总体效力 细分市场。 该方法将利用多元回归来估计系数 投入(住院天数和付款)和一些协变量(工作 分类、性别、年龄、终止概率和前几年 作为健康状态指示器的利用率)和其他虚拟控制 变量(行业、地点)。我们将审查这些项目的重要性，并 亚组之间的差异。马诺瓦还将用于测试 这些差异的意义，以及互动的重要性 效果。同时使用参数和非参数的聚合技术 转换，将用于控制DRG和 从而允许更大的样本大小用于测试假设。 最终结果将是按关键分区划分的特定信息 关于边际卫生保健支出有效性的制度。适用范围 政策和管理方面的关注都将得到强调。