Case-mix adjustment and efficiency measurement.
OBJECTIVE
The importance of using valid case-mix systems in long-term care is addressed by comparing the predictive power of different case-mix models, and by applying them in the calculation of technical efficiency scores of care units.


METHODS
To construct different case-mix models a statistical clustering technique (Automatic Interaction Detection) was used. Technical efficiency score were calculated using data envelopment analysis (DEA).


RESULTS
The Resource Utilization Groups (RUG-III/22) classification explained 39% of resident specific cost, compared with 16% for a functional dependency scale in the Finnish patient information system HILMO.


CONCLUSIONS
When assessing the economic performance of long-term care units it is important to pay attention to the predictive validity of the case-mix measure to be used. The choice of case-mix measure significantly affected how units were rated in efficiency.
Björkgren
Magnus A
MA
Chydenius Institute, Jyväskylä University, Kokkola, Finland. magnus.bjorkgren@chydenius.fi
Fries
Brant E
BE
Häkkinen
Unto
U
Brommels
Mats
M
D000203:Activities of Daily Living; D017598:Efficiency, Organizational; D005387:Finland; D006757:Hospital Units / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D015233:Models, Statistical; D009730:Nursing Assessment; D020379:Risk Adjustment