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Case-Mix Groups for VA Hospital-Based Home Care

Bibliographic Data

ID9103095
AuthorsMary E Smith (0000-0002-6203-317X, United States Department of Veterans Affairs, corresponding author), Carolyn Baker (John L. McClellan Memorial Veterans Hospital, corresponding author), C Rodney Baker, Laurence G Branch (United States Department of Veterans Affairs, corresponding author), Robert C Walls (University of Arkansas for Medical Sciences, corresponding author), Richard M Grimes (The University of Texas Health Science Center at Houston), Judith M Karklins (United States Department of Veterans Affairs, corresponding author), Michael Kashner (United States Department of Veterans Affairs, corresponding author), Rebecca Burrage, R H Burrage (University of Baltimore), Ann Parks (0000-0001-9779-6049, University of Baltimore), Peter Rogers (0000-0001-9420-1476, United States Department of Veterans Affairs), Paul Rogers (0000-0001-9176-4126), Ann Saczuk (Memphis Health Center), Marilyn Wagster-Weare (United States Department of Veterans Affairs)
Year1992
Volume30
Issue1
Pages1-16
Publication date1992-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199201000-00001
PMID1309585
OpenAlexW2091820121
LanguageEN
Citations received8
References cited5

The purpose of this study is to group hospital-based home care (HBHC) patients homogeneously by their characteristics with respect to cost of care to develop alternative case mix methods for management and reimbursement (allocation) purposes. Six Veterans Affairs (VA) HBHC programs in Fiscal Year (FY) 1986 that maximized patient, program, and regional variation were selected, all of which agreed to participate. All HBHC patients active in each program on October 1, 1987, in addition to all new admissions through September 30, 1988 (FY88), comprised the sample of 874 unique patients. Statistical methods include the use of classification and regression trees (CART software: Statistical Software; Lafayette, CA), analysis of variance, and multiple linear regression techniques. The resulting algorithm is a three-factor model that explains 20% of the cost variance (R2 = 20%, with a cross validation R2 of 12%). Similar classifications such as the RUG-II, which is utilized for VA nursing home and intermediate care, the VA outpatient resource allocation model, and the RUG-HHC, utilized in some states for reimbursing home health care in the private sector, explained less of the cost variance and, therefore, are less adequate for VA home care resource allocation

Business · Case mix index · Economics · Fiscal year · Health care · Home health · Operations management · Reimbursement · Sample (material) · Variance (accounting) · Veterans Affairs · Chronic Disease Management Strategies · Finance · Geriatric Care and Nursing Homes · Healthcare Policy and Management · Medicine · Nursing

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Unique citing works8
Citations per year0,24
Citation span1993 - 2006 (14)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 6
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