The business of palliative medicine--Part 2: The economics of acute inpatient palliative medicine.
Economic feasibility is a major factor in the viability of established acute inpatient palliative medicine. Several clinical, administrative, and financial parameters determine the financial health of inpatient care. Financial management metrics include case mix index (CMI) (as determined by the Federal Register as an assigned relative weight to the diagnosis-related group (DRG) reflecting resource consumption), direct costs, indirect costs, contribution margin, and in the future of all patient revised-DRG (APR-DRG). Both census and length of stay will have a major impact on these financial metrics. The type of patient referral and clinical decisions will influence direct costs and revenues. In the future, an international CMI or APR-DRG will allow palliative inpatient units to compare disease severity, resource utilization, and outcome measures.
Davis
Mellar P
MP
Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Ohio, USA.
Walsh
Declan
D
Nelson
Kristine A
KA
Konrad
Dale
D
LeGrand
Susan B
SB
Rybicki
Lisa
L
D000368:Aged; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D009820:Ohio; D010166:Palliative Care / Q000191:economics* / Q000379:methods*; D013727:Terminal Care / Q000191:economics*