Yu Wei, Wagner Todd H, Chen Shuo, Barnett Paul G
VA HSR&D Health Economics Resource Center, Stanford University, USA.
Med Care Res Rev. 2003 Sep;60(3 Suppl):40S-53S. doi: 10.1177/1077558703256724.
This article describes the development of a database for the cost of inpatient rehabilitation, mental health, and long-term care stays in the Department of Veterans Affairs from fiscal year 1998 forward. Using "bedsection," which is analogous to a hospital ward, the authors categorize inpatient services into nine categories: rehabilitation, blind rehabilitation, spinal cord injury, psychiatry, substance abuse, intermediate medicine, domiciliary, psychosocial residential rehabilitation, and nursing home. For each of the nine categories, they estimated a national and a local (i.e., medical center) average per diem cost. The nursing home average per diem costs were adjusted for case mix using patient assessment information. Encounter-level costs were then calculated by multiplying the average per diem cost by the number of days of stay in the fiscal year. The national cost estimates are more reliable than the local cost estimates.
本文描述了退伍军人事务部从1998财年起住院康复、心理健康和长期护理住院费用数据库的开发情况。作者使用类似于医院病房的“病床区”，将住院服务分为九类：康复、盲人康复、脊髓损伤、精神病学、药物滥用、中级医学、住所、心理社会住院康复和疗养院。对于这九类中的每一类，他们估计了全国和当地（即医疗中心）的每日平均费用。使用患者评估信息对疗养院的每日平均费用进行病例组合调整。然后通过将每日平均费用乘以财政年度的住院天数来计算每次就诊的费用。全国费用估计比当地费用估计更可靠。
