Accession Number : ADA258133


Title :   Estimating Post-hospital Use for Principal and Secondary Diagnoses


Corporate Author : RAND CORP SANTA MONICA CA


Personal Author(s) : Heilbrunn, Joanna Z ; Thomas, Neal


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a258133.pdf


Report Date : Aug 1990


Pagination or Media Count : 60


Abstract : One concern with any prospective payment system that bundles payment of post-hospital care with primary hospital care is the possibility that hospital administrators and doctors will learn to predict which types of patients will require post-hospital care. Since any extra post-hospital care would have to be paid by the hospital out of the fixed prospective payment, predictable variation in the use of post-hospital care within payment categories might create an incentive to exclude patients likely to require the most care. This Note demonstrates that knowledge of a patient's secondary diagnoses provides additional information about the patient's use of post-hospital care beyond that contained in the principal diagnosis. Unless a small number of secondary diagnoses can be identified that account for most of this additional variability in post-hospital use, refinement of the current diagnostic related group (DRG) system to account for differences among patients with differing secondary diagnoses will not e feasible. The study provides concrete evidence that knowledgeable administrators can skim desirable patients, not only from the current hospital DRG categories but also from categories defined by the principal diagnoses contained in the current DRG categories.


Descriptors :   *ESTIMATES , *DIAGNOSIS(MEDICINE) , *FEDERAL BUDGETS , MODELS , HOSPITALS , PUBLIC HEALTH , REHABILITATION , HEALTH CARE FACILITIES , PATIENTS , HEALTH


Subject Categories : Economics and Cost Analysis
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE