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资源强度权重与加拿大医院成本:一些初步数据。

Resource Intensity Weights and Canadian hospital costs: some preliminary data.

作者信息

Poole B, Robinson S, MacKinnon M

出版信息

Healthc Manage Forum. 1998 Spring;11(1):22-6. doi: 10.1016/S0840-4704(10)61000-9.

Abstract

Different types of inpatients "consume" differing amounts of hospital resources, and it is important to be able to measure these differences in resource consumption. An equitable methodology for funding hospitals must take into account differences in case mix between facilities. An ability to examine these differences in case mix and resource utilization allows hospitals to focus efforts to improve efficiency. A standardized methodology for measuring resource consumption is critical to funding and resource allocation both at a global and organizational level. This study was undertaken to determine whether or not the Canadian system for measuring resource consumption, Canadian Institute for Health Information (CIHI) RIWs, was reflective of the relative cost differences between inpatient cases at the Greater Victoria Hospital Society (GVHS) and to identify RIWs with a significant difference in comparison to GVHS cost weights. A regression analysis was performed on the more than 30,000 inpatient cost profile records from the GVHS 1995-96 cost and patient activity data. The scope of the analysis was restricted to the 424 Case Mix Groups (CMGs) that had a minimum composition of five patient profiles. Comparisons of GVHS cost weights to CIHI RIWs yielded mostly positive results. With the noted exception of about 20 CMGs, there was a high correlation between the CIHI RIW and the GVHS actual cost weights. Hence, the GVHS cost weights can be viewed with confidence as representative of the relative cost differences between typical RIW value CMGs and actual costs.

摘要

不同类型的住院患者“消耗”的医院资源数量不同,因此能够衡量这些资源消耗差异非常重要。一种公平的医院资金筹集方法必须考虑不同医疗机构之间病例组合的差异。能够研究病例组合和资源利用方面的这些差异,有助于医院集中精力提高效率。一种标准化的资源消耗衡量方法对于全球和组织层面的资金筹集与资源分配至关重要。本研究旨在确定加拿大的资源消耗衡量系统,即加拿大卫生信息研究所(CIHI)的相对住院日权重(RIWs),是否反映了大维多利亚医院协会(GVHS)住院病例之间的相对成本差异,并识别出与GVHS成本权重相比有显著差异的RIWs。对GVHS 1995 - 96年成本和患者活动数据中的30000多条住院成本概况记录进行了回归分析。分析范围限于424个病例组合组(CMGs),这些组至少由五个患者概况组成。GVHS成本权重与CIHI RIWs的比较大多得出了积极结果。除了约20个CMGs外,CIHI RIW与GVHS实际成本权重之间存在高度相关性。因此,可以放心地将GVHS成本权重视为典型RIW值CMGs与实际成本之间相对成本差异的代表。

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