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Case-mix adjustment and efficiency measurementChydenius Institute, Jyväskylä University, Kokkola, Finland and National Research and Development Centre for Welfare and Health, Health Services Research Unit, Helsinki, Finland, magnus.bjorkgren{at}chydenius.fi
Institute of Gerontology and School of Public Health, University of Michigan, Ann Arbor, Michigan, USA and Ann Arbor VA Medical Center, Ann Arbor, Michigan, USA
National Research and Development Centre for Welfare and Health, Health Services Research Unit, Helsinki, Finland
Department of Public Health, University of Helsinki, Finland and Medical Management Centre, Karolinska Institutet, Stockholm, Sweden Aims: The importance of using valid case-mix systems in long-term care is addressed by comparing the predictive power of different case-mix models, and by applying them in the calculation of technical efficiency scores of care units. Methods: To construct different case-mix models a statistical clustering technique (Automatic Interaction Detection) was used. Technical efficiency score were calculated using data envelopment analysis (DEA). Results: The Resource Utilization Groups (RUG-III/22) classification explained 39% of resident specific cost, compared with 16% for a functional dependency scale in the Finnish patient information system HILMO. Conclusion: When assessing the economic performance of long-term care units it is important to pay attention to the predictive validity of the case-mix measure to be used. The choice of case-mix measure significantly affected how units were rated in efficiency.
Key Words: case mix • data envelopment analysis • efficiency measurement • long-term care • Resource Utilization Groups.
Scandinavian Journal of Public Health, Vol. 32, No. 6,
464-471 (2004) This article has been cited by other articles:
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