Casemix classification payment for sub-acute and non-acute inpatient care, Thailand.
BACKGROUND
There is a need to develop other casemix classifications, apart from DRG for sub-acute and non-acute inpatient care payment mechanism in Thailand.


OBJECTIVE
To develop a casemix classification for sub-acute and non-acute inpatient service.


METHODS
The study began with developing a classification system, analyzing cost, assigning payment weights, and ended with testing the validity of this new casemix system. Coefficient of variation, reduction in variance, linear regression, and split-half cross-validation were employed.


RESULTS
The casemix for sub-acute and non-acute inpatient services contained 98 groups. Two percent of them had a coefficient of variation of the cost of higher than 1.5. The reduction in variance of cost after the classification was 32%. Two classification variables (physical function and the rehabilitation impairment categories) were key determinants of the cost (adjusted R2 = 0.749, p = .001). Validity results of split-half cross-validation of sub-acute and non-acute inpatient service were high.


CONCLUSIONS
The present study indicated that the casemix for sub-acute and non-acute inpatient services closely predicted the hospital resource use and should be further developed for payment of the inpatients sub-acute and non-acute phase.
Khiaocharoen
Orathai
O
Health Systems and Policy Programme, Faculty of Medicine, Naresuan University, Pitsanuloke, Thailand.
Pannarunothai
Supasit
S
Zungsontiporn
Chairoj
C
Riewpaiboon
Wachara
W
D000328:Adult; D000368:Aged; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics; D017050:Episode of Care; D005260:Female; D017048:Health Care Costs; D006757:Hospital Units / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000145:classification*; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012046:Rehabilitation / Q000145:classification / Q000191:economics; D012047:Rehabilitation Centers / Q000191:economics / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D019467:Subacute Care / Q000145:classification* / Q000191:economics; D013785:Thailand