White Chapin, Pizer Steven D, White Alan J
Harvard University, USA.
Health Care Financ Rev. 2002 Winter;24(2):7-15.
Resource utilization groups, version III (RUG-III) is used by CMS to classify skilled nursing facility (SNF) residents into Medicare payment groups. Using a sample of 1,304 SNF residents with Medicare-covered stays, we find that RUG-III only explains 10.4 percent of the variance in total per diem costs. RUG-III explains variance in staff-time costs fairly well, but does not explain variance in non-therapy ancillary costs. Receipt of special treatments such as intravenous medications and respiratory therapy is strongly associated with high residual costs (p < 0.01). Modifications to the RUG-III system can increase its variance explanation.
资源利用分组，第三版（RUG-III）被医疗保险和医疗补助服务中心（CMS）用于将熟练护理机构（SNF）的居民分类到医疗保险支付组中。通过对1304名有医疗保险覆盖住院时间的SNF居民样本进行研究，我们发现RUG-III仅解释了每日总费用方差的10.4%。RUG-III能较好地解释员工时间成本的方差，但不能解释非治疗辅助成本的方差。接受静脉用药和呼吸治疗等特殊治疗与高剩余成本密切相关（p < 0.01）。对RUG-III系统进行修改可以增加其对方差的解释力。
