Patterns of Ambulatory Care: Evaluation Research; an Empirical Evaluation of Selected Alternatives to Itemized Rates. Part 1: Final Report

摘要

The itemized approach gives detailed information on services rendered, but involves an overhead cost which contributes little towards prevention or cure of illness. This report presents findings from an empirical evaluation of selected alternatives to the itemized rate-calculation mechanism (RCM). Six alternative RCMs were evaluated on eleven criteria. The criteria were not weighted in terms of relative importance. No single alternative RCM was clearly superior on enough criteria to warrant advocating wholesale abandonment of the itemized approach. In future considerations, the results can be included as relatively systematic information on criteria used. Ambulatory care planners can apply the findings to particular clinic systems where criteria are assigned different, discernible priorities. Such differential weighting of criteria may yield a superior score for an alternative RCM which warrants its adoption in a particular system. A data base was developed contaning detailed information on services received by 2,500 patients during 6,500 visits at six facilities in L.A. County.