Miller M E, Sulvetta M B
Urban Institute, Washington, DC 20037.
Health Care Financ Rev. 1992 Winter;14(2):135-49.
Medicare expenditures of hospital outpatient department (HOPD) services are growing rapidly, prompting congressional interest in a prospective payment system. In this article, the authors identify frequently provided services and examine service volume and charges in the HOPD. Relatively few services drive Medicare HOPD spending, and volume is dominated by visits, imaging and laboratory tests, whereas surgery accounts for a large proportion of charges. Hospital-level variations in charges, costs, case mix, and outliers are also explored. There is substantial variation in charges and costs across hospital types. However, after case-mix adjustment, all hospital types have average costs within 6 percent of the national average.
医疗保险对医院门诊服务的支出增长迅速，促使国会对前瞻性支付系统产生兴趣。在本文中，作者识别了经常提供的服务，并研究了医院门诊部门的服务量和收费情况。相对较少的服务项目推动了医疗保险医院门诊支出，服务量主要由诊疗、影像和实验室检查构成，而手术费用占比很大。同时还探讨了医院层面在收费、成本、病例组合和异常值方面的差异。不同类型医院的收费和成本存在很大差异。然而，在进行病例组合调整后，所有类型医院的平均成本都在全国平均水平的6%以内。
