Prospective casemix-based funding, analysis and financial impact of cost outliers in all-patient refined diagnosis related groups in three Belgian general hospitals

被引：7
作者：
Pirson M. [1 ,4 ]
Martins D. [1 ]
Jackson T. [2 ]
Dramaix M. [3 ,4 ]
Leclercq P. [1 ]
机构：
[1] Health Economics Department, School of Public Health, Université de Bruxelles
[2] School of Public Health, LaTrobe University, Bundoora, Vic.
[3] Biostatistics, School of Public Health, Université Libre de Bruxelles, Brussels
[4] School of Public Health, Université Libre de Bruxelles, Brussels
来源：
The European Journal of Health Economics | 2006年 / 7卷 / 1期
关键词：
All-patient refined diagnosis related groups; Hospital costs; Hospital funding; Outliers; Prospective payment system;
D O I：
10.1007/s10198-005-0331-0
中图分类号：
学科分类号：
摘要：
This study examined the impact of cost outliers in term of hospital resources consumption, the financial impact of the outliers under the Belgium casemix-based system, and the validity of two "proxies" for costs: length of stay and charges. The cost of a 11 hospital stays at three Belgian general hospitals were calculated for the year 2001. High resource use outliers were selected according to the following rule: 75th percentile + 1.5 xinter-quartile range. The frequency of cost outliers varied from 7% to 8% across hospitals. Explanatory factors were: major or extreme severity of illness, longer length of stay, and intensive care unit stay. Cost outliers account for 22-30% of hospital costs. One-third of length-of-stay outliers are not cost outliers, and nearly one-quarter of charges outliers are not cost outliers. The current funding system in Belgium does not penalise hospitals having a high percentage of outliers. The billing generated by these patients largely compensates for costs generated. Length of stay and charges are not a good approximation to select cost outliers. © Springer Medizin Verlag 2006.
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页码：55 / 65
页数：10
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