0000000000505111
AUTHOR
Caryn Mathy
Modeling of medical activity heterogenity to improve the hospital management by diagnosis-related groups
Since the early 1980s healthcare systems in the industrialized nations have been undergoing radical reform aimed at curbing overspending of hospital expenditure. After a discussion of the limits of a prospective payment due to heterogeneity of costs within DRGs, we demonstrate the ability of anovel statistical model to identify high cost patients. We derive from this statistical model an economic heuristic in order to account for high cost patients in budget allocation and a Structural and Contingent method is proposed as a budgeting tool. Economic analysis based on this modeling of DRG heterogeneity further reveals the potential for improving the equity and the efficiency of the prospectiv…
De la standardisation à la normalisation de la gestion médicalisée à l'hôpital : L’apport de la méthode de compensation structurelle et conjoncturelle
Utilization of GHM in budget allocation leads to a reduction of strategic behaviors and restores equity between hospitals. However, heterogeneousness of GHM, with subgroups, is also generating perverse effects. The contractual economical analysis, applied to the statistical modelization of Quantin et al. (1995), underlines how the opportunist behaviors can be reduced. As the PMSI is almost unanimously adopted and considered as an irreversible investment, this approach generates questions on ways to improve the tool. The ultimate goal is to move from standardized costs tonormalized (optimized) costs for maximum efficiency of the tool. Finally, this statistical analysis generates a financial …