Biomedical subjects
Publications and source records attributed to P R Binner.
A form of cost--benefit analysis is used to measure the efficiency and effectiveness of an alcoholism treatment program in caring for patients grouped by year of admission, sex and level of impairment.
Three alternative methods for obtaining anticipated resource utilization information for comprehensive mental health centers are proposed. The methods differ on two dimensions, sample selection and statistical technique. Using an admission cohort rather than a discharge cohort and eliminating patients who terminated treatment against medical advice permitted a refined prediction. Although no significant differences were found between the chi-square and multiple-regression techniques, the latter resulted in a substantially greater degree of flexibility.
This study analyzes the relationship between program performance and workload levels. The results indicate that program effectiveness is highest under medium workloads while efficiency is greatest under high workloads. The management dilemma resulting from these findings is discussed.
The application of output value analysis, a type of benefit/cost analysis, to a psychiatric patient population is reported. A method for discounting the value of the program if a patient was readmitted within a year after discharge was introduced. The application of this discount factor reduces the value produced by the program and thereby reduces both productivity and effectiveness indices. When applied to groups known to differ in readmission rates, such as first admissions and readmissions or voluntary and involuntary admissions, the discount factor can accentuate group differences markedly. When selected diagnostic groups were compared, the discount factor could even reverse the relative standing of the groups.