Study to Develop and Test Measures of Case Mix Complexity, Case Mix Severity, and Case Volume for Hospitals. Part 1. Behavioral Cost Function Analysis. Part 2. The Effect of Case Volume on Medicare Inpatient Cost per Case

摘要

The report relates the methods and findings from 2 separate studies of how the cost per case of Medicare inpatients relates to certain patient factors. Behavioral cost function analysis was used to relate cost per case to case-mix measures of various kinds, and the effects of various co-variates. The other study focused on 12 homogenous surgical case types and examined how cost per case varied according to case volume when biasing variables were controlled. Both studies used 1978 data. The first study confirmed earlier studies which showed that cost per case is proportional to case-mix after controlling for bed-size, teaching, age levels and city population, and that increased data quality increases the variation in case-mix indices. It also showed that Medicare case-mix is not highly correlated with case-mix of under age 65 patients and that case-mix diversity measures do not significantly increase explanatory power. The second study found that a 35 percent decline in discharges average costs per case by 10 percent.