Contributions of case mix and intensity change to hospital cost increases.
The 28-percent change in average Medicare inpatient cost per case between 1984 and 1987 is decomposed into three components: input price inflation, changes in average cost within diagnosis-related groups (DRGs) (intensity), and changes in the distribution of cases across DRGs (case mix). We estimate the contributions of technology diffusion and outpatient shifts to within-DRG and across-DRG cost changes. We also use California data to estimate the contribution of changes in the quantity of services provided during a stay. The factors examined account for approximately 80 percent of the real increase in average cost per case.
Bradley
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TB
Prospective Payment Assessment Commission, Washington, DC 20024.
Kominski
G F
GF
D002140:California; D003361:Cost Allocation / Q000706:statistics & numerical data* / Q000639:trends; D003625:Data Collection; D003953:Diagnosis-Related Groups / Q000145:classification / Q000191:economics*; D004059:Diffusion of Innovation; D004469:Economics, Hospital / Q000706:statistics & numerical data*; D013677:Medical Laboratory Science / Q000191:economics; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data; D011445:Prospective Payment System / Q000191:economics; D014481:United States