Dayhoff D A, Cromwell J
Center for Health Economics Research, Waltham, MA 02154.
Health Serv Res. 1993 Aug;28(3):293-312.
This article conceptually and empirically evaluates alternative index measures that have been used to distinguish among hospital caseloads. It introduces two new measures.
DATA SOURCES/STUDY SETTING: The study relies on 1987 Medpar data, which provide a 100 percent sample of Medicare Part A claims for the calendar year.
Descriptive statistics indicate the sensitivity of alternative caseload measures to hospital bed size, region, and urban/rural location. Multiple regression analysis then examines the ability of the caseload measures to distinguish among hospitals based on hospital- and area-specific characteristics.
DATA COLLECTION/EXTRACTION METHODS: A provider level file containing the number of cases treated by each provider in each DRG was constructed from the Medpar data and merged with data from the American Hospital Association and the Area Resource File.
Different indexes purporting to measure hospital specialization are often evaluating very different aspects of the hospitals' caseloads. Prior work has indicated a specialization among hospitals during the period from 1980 to 1985. Replication of this work using other indexes could verify the increase in specialization and might provide a clearer picture of market or hospital characteristics associated with changing caseloads.
本文从概念和实证角度评估了用于区分医院病例量的替代指标。它引入了两种新指标。
数据来源/研究背景：该研究依赖于1987年的医疗保健机构医疗费用报表数据（Medpar数据），这些数据提供了该日历年医疗保险A部分索赔的100%样本。
描述性统计表明替代病例量指标对医院床位规模、地区以及城市/农村位置的敏感性。然后，多元回归分析检验病例量指标根据医院和地区特定特征区分不同医院的能力。
数据收集/提取方法：根据Medpar数据构建了一个提供者层面的文件，其中包含每个提供者在每个诊断相关分组（DRG）中治疗的病例数，并与美国医院协会和地区资源文件中的数据合并。
旨在衡量医院专业化程度的不同指标往往评估的是医院病例量非常不同的方面。先前的研究表明，1980年至1985年期间医院存在专业化现象。使用其他指标重复这项工作可以验证专业化程度的提高，并可能更清楚地了解与病例量变化相关的市场或医院特征。
