Phillips Charles D
Department of Health Policy and Management, School of Public Health, Health Science Center, Texas A&M University, College Station, TX, USA.
Health Serv Insights. 2015 Dec 28;8:35-43. doi: 10.4137/HSI.S35366. eCollection 2015.
Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.
病例组合分类和支付系统有助于确保有相似需求的人获得相似数量的护理资源，这是消费者、提供者和项目主要关注的公平问题。虽然针对成年人的健康服务项目经常使用病例组合支付系统，但为儿童和青少年提供健康服务的项目很少使用这种模式。本研究利用了美国一个大州2578名接受家庭护理儿童的医疗补助家庭护理支出和评估数据。通过分类和回归树分析，开发了一个长期儿科家庭护理的病例组合模型。儿科家庭护理/支出分类模型（P/ECM）将研究样本中的儿童和青少年分为24组，解释了年度家庭护理支出差异的41%。P/ECM为在面临严重医疗挑战的儿童和青少年中更公平、可能更有效地分配家庭护理资源创造了可能性。
