Helping physicians maintain control.
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Humans↗
Biomedical subjects
D L Knowlton
Publications and source records attributed to D L Knowlton.
HIV care: a capitated alternative.
Given sufficient and participatory planning, a cluster of excellence for HIV/AIDS could be designed that could yield benefits to payers, providers, and patients. Such a cluster of excellence would be at risk for all care provided to an enrollment population made up of PWAs and would be globally capitated based upon the average cost of providing care to this population in the current, unmanaged health care environment. The cluster would be freed from conventional use constraints and be free to manage the care of their enrollment population with minimal payer interference. But it would be at risk for managing the cost of care to the enrollees within the global capitation rate.
Acquired Immunodeficiency Syndrome↗
A study of the relationship between severity of illness and hospital cost in New Jersey hospitals.
In response to concerns over the equity of diagnosis-related group (DRG)-based prospective payment, the New Jersey Department of Health conducted a Severity of Illness evaluation study in which severity of illness, DRG, and uniform cost information were collected for 76,798 patients in 25 hospitals. Severity of illness was measured using the Computerized Severity Index (CSI) and was found to be a significant determinant of hospital cost in 76 DRGs that accounted for 41.4 percent of the total direct hospital patient care costs and 27 percent of the patients. The addition of CSI severity levels to the 76 DRGs reduced the coefficient of variation of cost in these DRGs by 17.4 percent and improved the overall reduction in variance of cost within the 76 DRGs by 38.2 percent. The change in total hospital payments due to the addition of severity for the 76 DRGs varied from a positive 5.71 percent to a negative 5.48 percent. These results demonstrate that a severity adjustment to this subset of DRGs would result in a more equitable DRG-based prospective payment system.
Diagnosis-Related Groups↗