Data alone are not enough for health care purchasers.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to M P Plomann.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This case study illustrates the use of case-mix information in budgetary decision making. Specifically, case-mix reports are used to evaluate a budget increase request and the effect of changing treatment patterns on the use of hospital services.
DRGs have increased the effort of healthcare organizations to control costs. But with increased cost containment comes the question of decreased quality of care. Can decreased cost and quality care coexist? Using physician-specified patterns of care in conjunction with cost accounting, cost-effective, quality patient care can be delivered. Resources can be allocated efficiently without compromising quality.
Considering whether or not to organize a preferred provider organization is a complex task. Managers will need to address many financial, legal, marketing, and organizational issues. In this case study, case-mix management information is used to address issues such as, types of patients to attract, businesses and insurance companies to include, physicians to recruit, and prices to charge, to enable the manager to make more informed decisions.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The following case study illustrates the use of case-mix information in the budget process. Using case-mix data from a management information system such as PBCS, hospital managers can obtain the assistance of those who influence the delivery of care to develop a sound statistical budget upon which to allocate available resources. Such a budget should be based on honest goals which can be used to evaluate actual accomplishments.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Managers and physicians need additional tools to define the hospital's product other than diagnosis related groups (DRGs), one of several patient classification systems. DRGs are one way to define the hospital product, the treated patient, and are useful in assessing the profitability of Medicare cases. For other management activities--pricing, developing physician practice profiles, utilization review, and quality assurance--a more relevant and homogeneous patient category may be needed. This article discusses general classification concepts as well as a process for hospital managers and physicians to choose and modify patient classification systems that fit their particular situations.