Prospective Payment System Evaluation Studies-Effects of the Prospective Payment System on Hospital Costs, Utilization, and Financial Condition

摘要

The paper first examines which hospitals could look forward in the long run to gaining or losing revenue under Prospective Payment System (PPS) if they made no changes in their casemix or costs. The authors classify hospitals into four quartiles ranging from those 'dim prospect' (GAIN Quartile 1) hospitals which could expect the largest losses in the long run to those 'brightest prospect' (GAIN Quartile 4) hospitals which could expect the largest long run gains in revenue. Next it examines the adjustments which hospitals made during the first three years of PPS. The authors find that all hospitals reduced their lengths of stay and staffing levels. The dimmest prospect hospitals tended to make proportionally larger reductions in LOS and staffing. They also had lower rates of increase in costs than hospitals which were under less pressure.