Use of the Decision Support System for VA cost-effectiveness research
Use of the Decision Support System for VA cost-effectiveness research
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DOI：
10.1097/00005650-199904002-00009
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发表时间：
1999-04-01
期刊：
影响因子：
3
通讯作者：
Rodgers, JH
中科院分区：
文献类型：
--
作者：
Barnett, PG;Rodgers, JH
背景退伍军人事务部正在采用决策支持系统（DSS）、计算机软件和数据库，其中包括一个成本会计系统，该系统确定医疗保健产品和病人护理人员的成本。一个为成本效益分析提供成本数据的系统应该提供有效的，详细的，全面的数据，可以aggregated.METHODS，DSS的设计进行了描述，并与这些标准进行了比较。从DSS的利用数据进行了比较与其他VA利用数据。35个医疗中心的DSS总成本数据与为医疗保险计划开发的相对资源权重进行了比较。3家机构的住院数据发现，DSS中3.7%的住院时间不在VA出院数据库中，而出院数据中7.6%的住院时间不在DSS中。DSS报告了门诊护理数据库中六个设施报告的门诊就诊率为68.8%至97.1%。基于来自35个VA设施的DSS数据的每个诊断相关组的相对权重与Medicare权重相关（相关系数为0.853）。如果克服了某些问题，DSS将对研究有用。很难区分长期和急性住院治疗。VA没有所有住院手术的完整数据库，因此DSS没有为他们分配具体费用。访问决策者级DSS数据的权限需要集中。研究人员可以提供改进DSS成本估算所需的反馈。全面的遭遇级摘录将有助于使用DSS进行研究。
BACKGROUND. The Department of Veterans Affairs is adopting the Decision Support System (DSS), computer software and databases which include a cost-accounting system which determines the cost of health care products and patient encounters.OBJECTIVES. A system for providing cost data for cost-effectiveness analysis should be provide valid, detailed, and comprehensive data that can be aggregated.METHODS, The design of DSS is described and compared with those criteria. Utilization data from DSS was compared with other VA utilization data. Aggregate DSS cost data from 35 medical centers was compared with relative resource weights developed for the Medicare program.RESULTS. Data on hospital stays at 3 facilities found that 3.7% of the stays in DSS were not in the VA discharge database, whereas 7.6% of the stays in the discharge data were not in DSS. DSS reported between 68.8% and 97.1% of the outpatient encounters reported by six facilities in the ambulatory care data base. Relative weights for each Diagnosis Related Group based on DSS data from 35 VA facilities correlated with Medicare weights (correlation coefficient of .853).CONCLUSIONS. DSS will be useful for research if certain problems are overcome. It is difficult to distinguish long-term from acute hospital care. VA does not have a complete database of all inpatient procedures, so DSS has not assigned them a specific cost. The authority to access encounter-level DSS data needs to be centralized. Researchers can provide the feedback needed to improve DSS cost estimates. A comprehensive encounter-level extract would facilitate use of DSS for research.