Case Mix

Author : Francis H. Roger France
Publisher : IOS Press
Page : 196 pages
File Size : 54,5 Mb
Release : 2001
Category : Cross-cultural studies
ISBN : 1586032178

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Case Mix by Francis H. Roger France Pdf

The case mix concept has been introduced in the USA more than twenty years ago in order to measure hospital productivity and to promote quality of care. The DRGs were selected by HCFA in 1983 as the case mix classification system for the MEDICARE prospective payment system (PPS). Many other countries have adopted the case mix concept after long periods of testing and accepting, but with large variations in data collection, information standards, grouping tools, financing methods and quality of care developments all over the world. Each country has developed a local clinical and political culture about case mix tools. The present book is intended to update the case mix situation, country by country.

Author : Dr Syed M. Aljunid,Dr Saad A. Ali Jadoo
Publisher : Partridge Publishing Singapore
Page : 152 pages
File Size : 43,7 Mb
Release : 2017-09-19
Category : Medical
ISBN : 9781543742909

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Development of Pharmacy Service Weights in the Implementation of Casemix System for Provider Payment by Dr Syed M. Aljunid,Dr Saad A. Ali Jadoo Pdf

This book outlines the use of the casemix system as a provider payment tool in the health system with special focus on cost of pharmacy services of in-patient care. Casemix system, which is traditionally called Diagnosis Related Groups or DRG in more advanced economies, is now being implemented in many developing countries that plan to or have embarked on social health insurance programs as a source of the health funding. Extensive research has been carried out by the authors involving 13,673 patients that were prescribed with 111,794 items of drugs and admitted to one of the premier teaching hospital in Malaysia. Data from this research was vigorously analysed to impute the pharmacy service weights of all relevant casemix groups. This book provides the best reference for pharmacy service weights that can be used as a guide for effective implementation of the casemix system in any country in the world that plans to use the system.

Author : Syed Aljunid,Eka Yoshida Syukri
Publisher : Partridge Publishing Singapore
Page : 114 pages
File Size : 42,8 Mb
Release : 2020-11-26
Category : Health & Fitness
ISBN : 9781543761726

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Using Casemix System for Hospital Reimbursement in Social Health Insurance Programme by Syed Aljunid,Eka Yoshida Syukri Pdf

Social Health Insurance (SHI) is one of the vehicles in achieving Universal Health Coverage. However, in many low- and middle-income countries, implementation of SHI failed to provide efficient and effective coverage due to poor provider payment method. Indonesia has introduced social health insurance in 2014. With the population of more than 270 million, Indonesia is the biggest country in the world that implemented SHI with casemix system (INA-CBG) as the prospective provider payment method. In this book, we presented an outcome of a study implemented in the largest hospital in Jakarta, Indonesia that compared the impact of using casemix system as provider payment method with fee-for-service. A total 32,227 outpatients and 8,270 inpatients medical records were reviewed and included in the study. In addition, a survey was also conducted among billing administrators to assess the cost of the billing process and their perceptions on the two reimbursement methods. The total hospital charges, length of stay of inpatients, rate of unnecessary admissions and cost of billing process were among the indicators of efficiency compared in the study between the two provider payment methods. The book provides comprehensive evidence to confirm the advantages of casemix system as an efficient provider payment method in SHI programme.

Author : Prof Dr Syed Mohamed Aljunid,Dr Irwan Saputra
Publisher : Partridge Publishing Singapore
Page : 147 pages
File Size : 49,9 Mb
Release : 2022-11-20
Category : Business & Economics
ISBN : 9781543771985

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Implementation of Casemix System as Prospective Provider Payment Method in Social Health Insurance: a Case Study of Acheh Provincial Health Insurance by Prof Dr Syed Mohamed Aljunid,Dr Irwan Saputra Pdf

The Government of Aceh Province in Indonesia has established the Social Health Insurance (SHI) called Jaminan Kesehatan Aceh (JKA) in 2006 that provide health coverage to all 4.6 million population of the province. Fee-for-service was initially used as the provider payment method in the programme until 2013. In 2014, in line with the National Health Insurance of Indonesia (Jaminan Kesehatan Nasional JKN), INA-CBG (Indonesia Case-Based Group) casemix system was adopted by JKA to replace the Fee-for-Service method. This book presents outcome of the evaluation done using a combination of qualitative and quantitative methods on the implementation of JKA programme. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using INA-CBG groups covering more than 17,000 cases. Quantitative data analysis revealed that overall, the hospitals received 32.4% higher income when reimbursed with casemix system (INA-CBG) as compared to fee-for-service. Type D hospital is the biggest gainer with 81.0% increase in income. In conclusion, the use of Casemix (INA-CBG) as a prospective payment method has benefitted the hospitals a lot. It is hope that additional resources gained through this programme will allow the hospitals to provide optimum care to the population.

Author : Anonim
Publisher : Unknown
Page : 1638 pages
File Size : 49,8 Mb
Release : 1994
Category : Medical care
ISBN : RUTGERS:43008000991457

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Health Care Financing Review by Anonim Pdf

Author : Anonim
Publisher : Unknown
Page : 958 pages
File Size : 41,7 Mb
Release : 1997-08-27
Category : Administrative law
ISBN : UIUC:30112059141348

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Federal Register by Anonim Pdf

Author : United States. Prospective Payment Assessment Commission
Publisher : Unknown
Page : 96 pages
File Size : 43,9 Mb
Release : 1988
Category : Diagnosis related groups
ISBN : UOM:39015022602356

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Report and Recommendations to the Secretary, U.S. Department of Health and Human Services by United States. Prospective Payment Assessment Commission Pdf

Author : United States. Congress. Senate. Committee on Finance. Subcommittee on Health
Publisher : Unknown
Page : 148 pages
File Size : 44,9 Mb
Release : 1984
Category : Hospitals
ISBN : PURD:32754076148026

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Adjustments in Medicare's Prospective Payment System by United States. Congress. Senate. Committee on Finance. Subcommittee on Health Pdf

Author : Anonim
Publisher : Unknown
Page : 62 pages
File Size : 43,5 Mb
Release : 2000
Category : Medicaid
ISBN : IOWA:31858037458225

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Case Mix Study for Nursing Facilities by Anonim Pdf

Author : Robert A Giacalone
Publisher : Routledge
Page : 285 pages
File Size : 55,8 Mb
Release : 2015-04-08
Category : Business & Economics
ISBN : 9781317454038

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The US Nursing Home Industry by Robert A Giacalone Pdf

An in-depth analysis of the nursing home industry in America -- its past, present, and future. It focuses on the business aspects of the industry, and provides a detailed examination of the main issues concerning all nursing homes -- trends in health care expenditures; the legislative history of the industry; growing demand for care and how to measure it; the present structure of the industry; funding and financing concerns; government regulation; inter-industry competition and opportunities for growth; global comparisons; and public policy considerations.

Author : William O. Cleverley
Publisher : Jones & Bartlett Learning
Page : 538 pages
File Size : 51,6 Mb
Release : 2002
Category : Business enterprises
ISBN : 0763724955

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Essentials of Health Care Finance by William O. Cleverley Pdf

Sixth edition coming in November! Essentials of Health Care Finance, Fifth Edition stands firmly in its place as the leading textbook in its coverage of health care finance. No other text so completely blends the best of current finance theory with the tools needed in day-to-day practice. This timely revision includes 20 chapters that encompass virtually the entire spectrum of the health care industry--providing new and expanded information reflecting payment system changes in the industry and broadening content and examples to include hospitals as well as organizations in other sectors of the health care industry.

Author : J. R. Butler
Publisher : Springer Science & Business Media
Page : 424 pages
File Size : 41,6 Mb
Release : 1995-01-31
Category : Business & Economics
ISBN : 0792332474

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Hospital Cost Analysis by J. R. Butler Pdf

Hospital Cost Analysis provides an overview of theoretical developments in the economic analysis of production and costs in the multiproduct firm, and discusses these developments. Following a lucid explanation of the concepts of jointness, input/output separability and returns to scale, a detailed discussion of the concept measurement and classification of hospital output is provided. A fundamental dilemma confronting economists interested in estimating hospital cost functions is highlighted, viz. the trade-off between flexibility in functional form and homogeneity within hospital output categories. Empirical results on the effects of case mix, scale and utilisation, public/private ownership, and the centralised administration of hospital systems on hospital costs are presented. The implications of hospital cost analysis for public policy with respect to hospital payment schemes, including schemes based on Diagnosis Related Groups (DRGs), are also considered. This book brings together the literature on hospital cost analysis with theoretical developments in the analysis of the multiproduct cost functions. It will be of considerable interest to teachers and students of health economics and health policy advisers interested in the determinants of hospital costs and the design of hospital payment schemes.

Author : Anonim
Publisher : Unknown
Page : 348 pages
File Size : 53,8 Mb
Release : 1991
Category : Medical care
ISBN : UOM:39015029948471

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Primary Care Research by Anonim Pdf

Author : United States. Congress. Senate. Special Committee on Aging
Publisher : Unknown
Page : 584 pages
File Size : 50,8 Mb
Release : 2024-06-07
Category : Older people
ISBN : UOM:39015026228372

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Developments in Aging by United States. Congress. Senate. Special Committee on Aging Pdf

Author : John Appleby,Nancy Devlin,David Parkin
Publisher : John Wiley & Sons
Page : 120 pages
File Size : 51,7 Mb
Release : 2015-11-24
Category : Medical
ISBN : 9781118948590

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Using Patient Reported Outcomes to Improve Health Care by John Appleby,Nancy Devlin,David Parkin Pdf

A practical, introductory guide to the best use of Patient Reported Outcomes (PROs) to improve the quality of health care and patient health. Only title to exclusively introduce, explain and show how PROs can be best used to improve healthcare and patient outcomes Includes real life examples and case studies of PROs in practice Assesses the growing evidence base for PROs in practice Editor team from Office of Health Economics (OHE), The King's Fund and King’s College London with contributions from practising clinicians, GPs and other healthcare professionals