Shew Paul A, Sanders Sheryl L, Arthur Noelle C, Bush Kenneth W
Providence Home Services Portland West, Portland, Oregon, USA.
Home Healthc Nurse. 2010 Jan;28(1):31-6. doi: 10.1097/01.NHH.0000366795.71528.ac.
One of the outcomes of the initial Outcome and Assessment Information Set (OASIS) is to establish a level of reimbursement through the Medicare Prospective Payment System (PPS). Several inter-rater reliability (IRR) studies have noted differences in responses to individual questions within the OASIS but little is known about how variations in scoring might affect the final reimbursement projection. In a one-way repeated measures design study, the OASIS was completed on 52 patients by both an RN and a PT within a 24-hour timeframe and the projected reimbursement rates were compared. Fifty-four percent of the outcomes of the assessment pairs were identical; differences in the remaining 46% were equally divided between RNs and PTs in projecting a higher reimbursement rate and with similar distributions. The mean difference in projected reimbursement rates was $16.43 per episode with no significant difference between the PT and RN Home Health Resource Group (HHRG) distributions.
初始的结果与评估信息集（OASIS）的成果之一是通过医疗保险预期支付系统（PPS）确定报销水平。多项评分者间信度（IRR）研究指出，对OASIS中各个问题的回答存在差异，但对于评分差异如何影响最终报销预测知之甚少。在一项单因素重复测量设计研究中，一名注册护士（RN）和一名物理治疗师（PT）在24小时内对52名患者完成了OASIS，并比较了预计报销率。评估配对结果中有54%是相同的；其余46%的差异在预测更高报销率时，在注册护士和物理治疗师之间平均分配，且分布相似。预计报销率的平均差异为每例16.43美元，物理治疗师和注册护士的家庭健康资源组（HHRG）分布之间无显著差异。
