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Healthcare tariffs for specialist inpatient neurorehabilitation services: rationale and development of a UK casemix and costing methodology.
- Source :
-
Clinical rehabilitation [Clin Rehabil] 2012 Mar; Vol. 26 (3), pp. 264-79. Date of Electronic Publication: 2011 Oct 04. - Publication Year :
- 2012
-
Abstract
- Objective: To describe the rationale and development of a casemix model and costing methodology for tariff development for specialist neurorehabilitation services in the UK.<br />Rationale for Development of a New Methodology: Patients with complex needs incur higher treatment costs. Fair payment should be weighted in proportion to costs of providing treatment, and should allow for variation over time CASEMIX MODEL AND BAND-WEIGHTING: Case complexity is measured by the Rehabilitation Complexity Scale (RCS). Cases are divided into five bands of complexity, based on the total RCS score. The principal determinant of costs in rehabilitation is staff time. Total staff hours/week (estimated from the Northwick Park Nursing and Therapy Dependency Scales) are analysed within each complexity band, through cross-sectional analysis of parallel ratings. A 'band-weighting' factor is derived from the relative proportions of staff time within each of the five bands.<br />Costing Methodology: Total unit treatment costs are obtained from retrospective analysis of provider hospitals' budget and accounting statements. Mean bed-day costs (total unit cost/occupied bed days) are divided broadly into 'variable' and 'non-variable' components. In the weighted costing model, the band-weighting factor is applied to the variable portion of the bed-day cost to derive a banded cost, and thence a set of cost-multipliers. Preliminary data from one unit are presented to illustrate how this weighted costing model will be applied to derive a multilevel banded payment model, based on serial complexity ratings, to allow for change over time.
- Subjects :
- Cost-Benefit Analysis
Female
Humans
Inpatients statistics & numerical data
Male
Models, Economic
Nervous System Diseases diagnosis
Rehabilitation Centers economics
Rehabilitation Centers statistics & numerical data
United Kingdom
Diagnosis-Related Groups economics
Health Care Costs statistics & numerical data
Nervous System Diseases rehabilitation
Specialization economics
State Medicine economics
Subjects
Details
- Language :
- English
- ISSN :
- 1477-0873
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Clinical rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 21971751
- Full Text :
- https://doi.org/10.1177/0269215511417467