卫生服务研究中疾病成本分析的发作分组实用指南。
A practical guide to episode groupers for cost-of-illness analysis in health services research.
作者信息
Peterson Cora, Grosse Scott D, Dunn Abe
机构信息
National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
National Center for Birth Defects and Developmental Disabilities Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
出版信息
SAGE Open Med. 2019 Mar 29;7:2050312119840200. doi: 10.1177/2050312119840200. eCollection 2019.
Abstract
Despite the prominence of episode groupers for analysis and reimbursement in US payer settings, peer-reviewed articles using episode groupers for cost-of-illness analysis that informs public health research and decision-making are uncommon. This article provides a brief practical guide to episode-based cost analysis and offers some examples of episode grouper products. It is intended for an audience of health services researchers and managers in public health settings who perform or commission cost-of-illness studies with the US healthcare claims fee-for-service data but lack familiarity with episode groupers.
摘要
尽管在美国医保支付方环境中，疾病分组工具在分析和报销方面具有显著地位，但利用疾病分组工具进行疾病成本分析以指导公共卫生研究和决策的同行评审文章却并不常见。本文提供了一份基于疾病分组的成本分析简要实用指南，并列举了一些疾病分组工具产品的示例。本文面向公共卫生领域的卫生服务研究人员和管理人员，他们使用美国医疗保健索赔按服务收费数据进行或委托开展疾病成本研究，但对疾病分组工具并不熟悉。
相似文献
1
A practical guide to episode groupers for cost-of-illness analysis in health services research.卫生服务研究中疾病成本分析的发作分组实用指南。
SAGE Open Med. 2019 Mar 29;7:2050312119840200. doi: 10.1177/2050312119840200. eCollection 2019.
2
Need for risk adjustment in adapting episode grouping software to Medicare data.在使发作分组软件适用于医疗保险数据时进行风险调整的必要性。
Health Care Financ Rev. 2009 Summer;30(4):33-46.
3
Financial Margins for Prostate Cancer Surgery: Quantifying the Impact of Modifiable Cost Inputs in an Episode Based Reimbursement Model.前列腺癌手术的财务利润率：基于按病种付费模型量化可调整成本投入的影响。
J Urol. 2019 Sep;202(3):539-545. doi: 10.1097/JU.0000000000000283. Epub 2019 Aug 8.
4
The impact of alternative cost recovery schemes on access and equity in Niger.替代成本回收计划对尼日尔医疗服务可及性和公平性的影响。
Health Policy Plan. 1995 Sep;10(3):223-40. doi: 10.1093/heapol/10.3.223.
5
Episode-Based Payment and Direct Employer Purchasing of Healthcare Services: Recent Bundled Payment Innovations and the Geisinger Health System Experience.基于 episode 的医疗服务付费与雇主直接购买：近期捆绑式付费创新及盖辛格医疗系统的经验
Neurosurgery. 2017 Apr 1;80(4S):S50-S58. doi: 10.1093/neuros/nyx004.
6
Cost of treating seriously mentally ill persons with HIV following highly active retroviral therapy (HAART).高效抗逆转录病毒疗法（HAART）治疗合并严重精神疾病的HIV感染者的成本。
J Ment Health Policy Econ. 2009 Dec;12(4):187-94.
7
Episodes of care: theoretical frameworks versus current operational realities.
Jt Comm J Qual Improv. 1999 Mar;25(3):111-28. doi: 10.1016/s1070-3241(16)30431-x.
8
Cost of care for Medicaid recipients with serious mental illness and HIV infection or AIDS.患有严重精神疾病且感染了艾滋病毒或患艾滋病的医疗补助受助者的护理费用。
Psychiatr Serv. 2003 Sep;54(9):1240-6. doi: 10.1176/appi.ps.54.9.1240.
9
Cost of illness for childhood diarrhea in low- and middle-income countries: a systematic review of evidence and modelled estimates.低收入和中等收入国家儿童腹泻的疾病成本：证据的系统评价与模型估计
BMC Public Health. 2020 May 5;20(1):619. doi: 10.1186/s12889-020-08595-8.
10
A comparison by payor/provider type of the cost of dying among frail older adults.按付款人/提供者类型对体弱老年人临终成本进行的比较。
J Am Geriatr Soc. 1996 Sep;44(9):1098-107. doi: 10.1111/j.1532-5415.1996.tb02947.x.
引用本文的文献
1
An episode-based cost analysis of virtual-first versus in-person-first care to treat common acute conditions among members of a large national payor.一项针对大型全国性医保机构成员中常见急性病的虚拟优先与面对面优先护理的基于事件的成本分析。
BMC Health Serv Res. 2025 Jul 29;25(1):994. doi: 10.1186/s12913-025-13154-1.
2
Economic Cost of U.S. Suicide and Nonfatal Self-harm.美国自杀和非致命性自伤的经济成本。
Am J Prev Med. 2024 Jul;67(1):129-133. doi: 10.1016/j.amepre.2024.03.002. Epub 2024 Mar 12.
3
The Health and Economic Impact of Youth Violence by Injury Mechanism.按伤害机制划分的青少年暴力对健康和经济的影响
Am J Prev Med. 2024 May;66(5):894-898. doi: 10.1016/j.amepre.2023.12.019. Epub 2023 Dec 23.
4
Determining prescriptions in electronic healthcare record data: methods for development of standardized, reproducible drug codelists.在电子健康记录数据中确定处方：标准化、可重复的药品代码列表的开发方法。
JAMIA Open. 2023 Aug 29;6(3):ooad078. doi: 10.1093/jamiaopen/ooad078. eCollection 2023 Oct.
5
Systematic Review of Per Person Violence Costs.个体暴力成本的系统评价
Am J Prev Med. 2024 Feb;66(2):342-350. doi: 10.1016/j.amepre.2023.08.009. Epub 2023 Aug 10.
6
Impact of the COVID-19 pandemic on treatment for mental health needs: a perspective on service use patterns and expenditures from commercial medical claims data.新冠疫情对心理健康需求治疗的影响：基于商业医疗理赔数据的服务使用模式和支出观察。
BMC Health Serv Res. 2023 Feb 16;23(1):163. doi: 10.1186/s12913-023-09080-9.
7
Assessment of Annual Cost of Substance Use Disorder in US Hospitals.评估美国医院物质使用障碍的年度成本。
JAMA Netw Open. 2021 Mar 1;4(3):e210242. doi: 10.1001/jamanetworkopen.2021.0242.
8
Changes in Health Services Use Among Commercially Insured US Populations During the COVID-19 Pandemic.在 COVID-19 大流行期间，美国商业保险人群健康服务使用的变化。
JAMA Netw Open. 2020 Nov 2;3(11):e2024984. doi: 10.1001/jamanetworkopen.2020.24984.
本文引用的文献
1
Two-Year Evaluation of Mandatory Bundled Payments for Joint Replacement.强制性捆绑支付在关节置换方面的两年评估。
N Engl J Med. 2019 Jan 17;380(3):252-262. doi: 10.1056/NEJMsa1809010. Epub 2019 Jan 2.
2
Evaluation of Medicare's Bundled Payments Initiative for Medical Conditions.医疗保险捆绑支付计划对医疗状况的评估。
N Engl J Med. 2018 Jul 19;379(3):260-269. doi: 10.1056/NEJMsa1801569.
3
The Next Generation of Episode-Based Payments.下一代基于诊疗事件的付费方式。
JAMA. 2017 Jun 20;317(23):2371-2372. doi: 10.1001/jama.2017.5902.
4
Episode-based payment: evaluating the impact on chronic conditions.基于诊疗 episode 的付费：评估对慢性病的影响。
Medicare Medicaid Res Rev. 2013 Sep 13;3(3). doi: 10.5600/mmrr.003.03.a07. eCollection 2013.
5
Geographic variation in commercial medical-care expenditures: a framework for decomposing price and utilization.商业医疗保健支出的地域差异：价格与利用率分解框架
J Health Econ. 2013 Dec;32(6):1153-65. doi: 10.1016/j.jhealeco.2013.09.006. Epub 2013 Sep 24.
6
Physicians' opinions about reforming reimbursement: results of a national survey.医生对改革报销制度的看法：一项全国性调查的结果。
Arch Intern Med. 2010 Oct 25;170(19):1735-42. doi: 10.1001/archinternmed.2010.369.
7
Developing a prospective payment system based on episodes of care.基于护理事件制定前瞻性支付系统。
J Ambul Care Manage. 2009 Jul-Sep;32(3):241-51. doi: 10.1097/JAC.0b013e3181ac9d6f.
Zotero 插件