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Biomedical subjects

R P Ament

Publications and source records attributed to R P Ament.

7 recordsLinked to original sources
PubMed1987

The effect of PPS on hospital product and productivity.

The results suggest that Prospective Payment System (PPS) prompted a reduction in the proportion of Medicare patients that were discharged, for whom the hospital considered the episode of care to be completed. The results also show a reduction in the proportion of patients discharged dead. When controlling for patient type, the results support the findings, but the magnitude of the change that might be attributed to PPS is somewhat smaller. Proportional changes in the input measures for all patients were next considered. The results indicate that fewer diagnostic tests, fewer laboratory tests, and fewer x-rays were used in 1984. Laboratory tests showed the most dramatic decrease. LOS decreased, but the drug input remained fairly constant. A productivity index that reflects the change in the input measure while controlling for patient type was developed. The results provide strong evidence of a productivity increase in all products for Medicare patients. The drug input did not contribute to the productivity increase. The 50 most frequent DRGs for Medicare patients were examined separately for productivity changes by product. The results further support the findings of an increase in productivity.

Commission on Professional and Hospital Activities↗
PubMed1982

Three case-type classifications: suitability for use in reimbursing hospitals.

This study compared three case-type classifications--the cross-classification of the Commission on Professional and Hospital Activities, Diagnosis-Related Groups (DRGs) and Staging--with respect to per cent of variance in total patient charges accounted for. The purpose was to assess the relative usefulness of the classifications for application in hospital reimbursement schemes. The sample consisted of 50 hospitals. A nested analysis of variance was performed with case type nested within hospital. Per cent of variance accounted for was calculated for each of three data sets: the full data set, a truncated version of that set and a logarithmically transformed version. Results support the contention that none of the currently available classifications accounts for enough variance to permit straightforward use of case-type standard costs in a reimbursement mechanism. New developments in case-type classification may result in a classification that is more suitable for this use.

Analysis of Variance↗
PubMed1981

Case mix complexity differences between teaching and nonteaching hospitals.

In the study reported here, the authors measured the differences between teaching and nonteaching hospitals in case mix complexity and provided some detail concerning the differences. They measured case complexity in a sample of 200 short-term general hospitals by the Resource Need Index (RNI) using a cross-classification of 3,490 case types with weights compiled from patient charges. Median RNI values were moderately higher for teaching than for nonteaching hospitals both for the hospital as a whole and for each clinical service except obstetrics-gynecology. The most resource-intensive case type were relatively more frequent in the teaching hospitals, but the least resource-intensive types were of about equal relative frequency in the two hospital groups. The results show that teaching hospitals could be expected to cost somewhat more per patient even if case mix were the only factor.

Costs and Cost Analysis↗