Abstract：
:In this paper I propose a methodology for paying short-term general hospitals on the basis of prospective cost-based case-mix revenue budgets. A hospital's budget is divided into patient care--related components and other components. The patient care--related budget is based on the case mix of patients treated by the hospital. Diagnosis-related groupings of patients are developed and a revenue per case amount is calculated for each group, based on reasonable costs of treatment, with a profit incentive for cost reduction resulting from improvements in productivity, efficiency, or more rational delivery of hospital services. The institutional budget is calculated on the basis of interinstitutional comparisons using a peer grouping method. I discuss various fundamental issues related to payment including paying for bad debt and indigency, the effect of insurance coverage, and a regional approach to capital funding. Case-mix payment allow for closer integration of payer programs with the activities of Professional Standards Review Organizations and health planning agencies. Additionally, payment based on the treatment of patients encourages a clear-cut management relationship between physician activities and hospital programs.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Reiss JBsubject
Has Abstractpub_date
1980-07-01 00:00:00pages
161-75issue
2eissn
0017-9124issn
1475-6773journal_volume
15pub_type
杂志文章abstract：OBJECTIVE:To estimate county-level associations between in utero exposure to threatened evictions and preterm birth in the United States. DATA SOURCES:Complete birth records were obtained from the National Center for Health Statistics (2009-2016). Threatened evictions were measured at the county level using eviction c...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13551
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVE:To assess the impact of out-migration of nurses on the health systems in sub-Saharan Africa (SSA). SETTING:The countries of SSA. DESIGN AND METHODS:Review of secondary sources: existing publications and country documents on the health workforce; documents prepared for the Joint Learning Initiative Global Hu...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2007.00712.x
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. DATA SOURCES:California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US C...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12324
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To determine the impact of rising health insurance premiums on coverage rates. DATA SOURCES & STUDY SETTING:Our analysis is based on two cohorts of nonelderly Americans residing in 64 large metropolitan statistical areas (MSAs) surveyed in the Current Population Survey in 1989-1991 and 1998-2000. Measures of...
journal_title：Health services research
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1475-6773.2005.00409.x
更新日期：2005-08-01 00:00:00
abstract：OBJECTIVE:We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. DATA SOURCE:Uninsured U.S. citizens and noncitizens from the 2005-2006 and 2008-2009 Medical Expenditure Panel Survey. ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12193
更新日期：2014-12-01 00:00:00
abstract：:Mr. Zamberlan is one of seven major executives in the Department of Veterans Affairs (VA) Veterans Health Services and Research Administration (VHS&RA), directing health care in a five-state region that includes 21 medical centers, 7 outpatient clinics, and 19 veterans outreach centers. As a medical center director in...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：BACKGROUND:Racial and ethnic disparities in health and health care have been documented; the elimination of such disparities is currently part of a national agenda. In order to meet this national objective, it is necessary that measures identify accurately the true prevalence of the construct of interest across diverse...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：10.1111/j.1475-6773.2005.00450.x
更新日期：2005-10-01 00:00:00
abstract：OBJECTIVE:To examine the association between bodyweight status and provision of population-based prevention services. DATA SOURCES:The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 20...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01447.x
更新日期：2013-04-01 00:00:00
abstract：OBJECTIVE:To extend recent conceptual and methodological advances in disparities research to include the incorporation of genomic information in analyses of racial/ethnic disparities in health care and health outcomes. DATA SOURCES:Published literature on human genetic variation, the role of genetics in disease and re...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2012.01413.x
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:To assess the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. STUDY SETTING:A total of 219 small primary care p...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13571
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:To examine the effects of varying diagnostic and pharmaceutical criteria on the performance of claims-based algorithms for identifying beneficiaries with hypertension, heart failure, chronic lung disease, arthritis, glaucoma, and diabetes. STUDY SETTING:Secondary 1999-2000 data from two Medicare+Choice healt...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2004.00321.x
更新日期：2004-12-01 00:00:00
abstract：OBJECTIVE:To assess hospital and geographic variability in 30-day mortality after surgery for CRC and examine the extent to which sociodemographic, area-level, clinical, tumor, treatment, and hospital characteristics were associated with increased likelihood of 30-day mortality in a population-based sample of older CRC...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12171a
更新日期：2014-08-01 00:00:00
abstract：OBJECTIVE:To compare estimates of health coverage from the pre- and post- redesign of the Current Population Survey (CPS) Annual Social and Economic Supplement. DATA SOURCES/STUDY SETTING:The CPS 2013 Content Test. STUDY DESIGN:A test of the old and new CPS in which the control panel was a subset of the CPS productio...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12312
更新日期：2016-02-01 00:00:00
abstract：:In a randomized trial of the effects of medical insurance on spending and the health status of the nonaged, we previously reported that patients with limited cost sharing had approximately one-third less use of medical services, similar general self-assessed health, and worse blood pressure, functional far vision, and...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1987-08-01 00:00:00
abstract：OBJECTIVE:To estimate the total hours of paid and unpaid personal assistance of daily living provided to adults living at home in the United States using nationally representative household survey data. DATA SOURCES:The Disability Followback Survey of the National Health Interview Survey on Disability (NHIS-D) conduct...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.029
更新日期：2002-04-01 00:00:00
abstract：:One method used to determine utilization rates of cervical screening is women's self-report. Few studies have assessed the accuracy of this measure--none has been conducted in Australia--although there are a number of reasons for suspecting its validity. This study examined and quantified the accuracy of self-report o...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
abstract：OBJECTIVE:To estimate the effect of a nursing home's share of residents with a serious mental illness (SMI) on the quality of care. DATA SOURCES:Secondary nursing home level data over the period 2000 through 2008 obtained from the Minimum Data Set, OSCAR, and Medicare claims. STUDY DESIGN:We employ an instrumental va...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12023
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVES:To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. DATA SOURCES/STUDY SETTING:Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eig...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00622.x
更新日期：2007-04-01 00:00:00
abstract：:A model is described that predicts hospital census and computes, for each day, the number of elective admissions that will maximize the census over the short run, subject to constraints on the probability of overflow. Where a computer is available the model provides detailed predictions of census in units as small as ...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
abstract：OBJECTIVE:To produce cost estimates of proposed health insurance benefit mandates for the California legislature. DATA SOURCES:The 2001 California Health Interview Survey, 2002 Kaiser Family Foundation/Health Research and Education Trust California Employer Health Benefits Survey, Milliman Health Cost Guidelines, and ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00518.x
更新日期：2006-06-01 00:00:00
abstract：:Does a prepaid group practice relative to comparable fee-for-service plans lead to different mental health outcomes for its beneficiaries? To answer this question, we used data from the RAND Health Insurance Experiment. We observed no statistically significant or clinically meaningful differences in mental health outc...
journal_title：Health services research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-10-01 00:00:00
abstract：OBJECTIVE:To determine whether assigning a dedicated general practitioner (GP) to a nursing home reduces hospitalizations and readmissions. DATA SOURCES/STUDY SETTING:Secondary data on hospitalizations and deaths by month for the universe of nursing home residents in Denmark from January 2011 through February 2014. S...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.13112
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. DATA SOURCES/STUDY SETTING:Primary data were collected on 5,314 nursing home residents in 156 ...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2006.00627.x
更新日期：2007-04-01 00:00:00
abstract：OBJECTIVE:Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on qual...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12035
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:To determine how the inclusion of post-acute evaluation and management (E&M) services as primary care affects assignment of Medicare beneficiaries to accountable care organizations (ACOs). DATA SOURCES:Medicare claims for a random 5 percent sample of 2009 Medicare beneficiaries linked to American Medical Ass...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12032
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:To develop a taxonomy of governing board roles in U.S. hospitals. DATA SOURCES:2005 AHA Hospital Governance Survey, 2004 AHA Annual Survey of Hospitals, and Area Resource File. STUDY DESIGN:A governing board taxonomy was developed using cluster analysis. Results were validated and reviewed by industry exper...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2008.00835.x
更新日期：2008-08-01 00:00:00
abstract：OBJECTIVE:To assess the impact of substance abuse claims redaction on Medicare spending estimates for beneficiaries with serious mental illness. DATA SOURCES:The 2012 claims and unredacted beneficiary-level Medicare spending totals from CMS's Chronic Conditions Warehouse. STUDY DESIGN:We identified beneficiaries with...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/1475-6773.12528
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVE:To summarize the state of the art in quality improvement, review its application to care for children, and define the information that will be needed so that care for children can be further improved. PRINCIPAL FINDINGS:Health services for children exhibit numerous deficiencies in quality of care. The defici...
journal_title：Health services research
pub_type： 杂志文章,评审
doi：
更新日期：1998-10-01 00:00:00
abstract：OBJECTIVE:To determine the effect of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on birth outcomes. DATA SOURCE:The Child Development Supplement (CDS) of the Panel Study of Income Dynamics (PSID). The PSID provides extensive data on the income and well-being of a representative sa...
journal_title：Health services research
pub_type： 杂志文章
doi：10.1111/j.1475-6773.2010.01115.x
更新日期：2010-08-01 00:00:00
abstract：OBJECTIVE:To examine the implications of serious and chronic health problems on the willingness of enrollees to switch health plans if they are dissatisfied with their current arrangements. DATA SOURCE:A large (20,283 respondents) survey of employees of three national corporations committed to the model of managed com...
journal_title：Health services research
pub_type： 杂志文章
doi：
更新日期：1999-06-01 00:00:00
