Carter Grace M, Relles Daniel A, Ridgeway Gregory K, Rimes Carolyn M
Health Care Financ Rev. 2003 Spring;24(3):25-44.
We studied 186,766 Medicare discharges to the community in 1999 from 694 inpatient rehabilitation facilities (IRF). Statistical models were used to examine the relationship of functional items and scales to accounting cost within impairment categories. For most items, more independence leads to lower costs. However, two items are not associated with cost in the expected way. The probable causes of these anomalies are discussed along with implications for payment policy. We present the rules used to construct administratively simple, homogeneous, resource use groups that provide reasonable incentives for access and quality care and that determine payments under the new IRF prospective payment system (PPS).
我们研究了1999年694家住院康复机构（IRF）中186,766例医疗保险出院患者转至社区的情况。运用统计模型来检验功能项目和量表与损伤类别内核算成本之间的关系。对于大多数项目而言，独立性越高成本越低。然而，有两个项目与成本的关联并非如预期那样。我们讨论了这些异常情况的可能原因以及对支付政策的影响。我们介绍了用于构建行政上简单、同质、资源使用组的规则，这些规则为获得医疗服务和优质护理提供合理激励，并确定新的住院康复机构前瞻性支付系统（PPS）下的支付金额。
