Buchanan Joan L, Andres Patricia L, Haley Stephen M, Paddock Susan M, Zaslavsky Alan M
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA.
Health Care Financ Rev. 2003 Spring;24(3):45-60.
Policymakers hoped to substitute a new, multi-purpose, functional assessment instrument, the minimum data set post-acute care (MDS-PAC), into the planned prospective payment system (PPS) for inpatient rehabilitation hospitals. PPS design requires a large database linking treatment costs with measures of the need for care, so the PPS was designed using the functional independence measure (FIM) database linked to Medicare hospital claims. An accurate translation from the MDS-PAC items to FIM--like items was needed to ensure payment equity under the substitution. This article describes the translation efforts and some of the problems that led policymakers to abandon the effort.
政策制定者希望将一种新的、多用途的功能评估工具——急性后期护理最小数据集(MDS-PAC),纳入为住院康复医院计划的前瞻性支付系统(PPS)中。PPS的设计需要一个将治疗成本与护理需求指标相联系的大型数据库,因此PPS是使用与医疗保险医院索赔相关联的功能独立性测量(FIM)数据库来设计的。需要将MDS-PAC项目准确翻译为类似FIM的项目,以确保在替代情况下的支付公平性。本文描述了翻译工作以及导致政策制定者放弃这项工作的一些问题。