Branch L G, Goldberg H B
Abt Associates Inc., Cambridge, MA 02138-1168.
Med Care. 1993 Apr;31(4):309-21. doi: 10.1097/00005650-199304000-00003.
In this study, a hierarchical case-mix model was developed for grouping Medicare home health beneficiaries homogeneously, based on the allowed charges for their home care. Based on information from a two-page form from 2,830 clients from ten states and using the classification and regression trees method, a four-component model was developed that yielded 11 case-mix groups and explained 22% of the variance for the test sample of 1,929 clients. The four components are rehabilitation, special care, skilled-nurse monitoring, and paralysis; each are categorized as present or absent. The range of mean-allowed charges for the 11 groups in the total sample was $473 to $2,562 with a mean of $847. Of the six groups with mean charges above $1,000, none exceeded 5.2% of clients; thus, the high-cost groups are relatively rare.
在本研究中，基于医疗保险家庭健康受益人的家庭护理允许费用，开发了一种分层病例组合模型，用于将他们进行同质分组。根据来自十个州的2830名客户的两页表格信息，并使用分类与回归树方法，开发了一个包含四个组成部分的模型，该模型产生了11个病例组合组，并解释了1929名客户测试样本中22%的方差。这四个组成部分是康复、特殊护理、熟练护士监测和瘫痪；每个部分都分为存在或不存在。总样本中11个组的平均允许费用范围为473美元至2562美元，平均为847美元。在平均费用高于1000美元的六个组中，没有一个组超过客户总数的5.2%；因此，高成本组相对较少。
