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Comparative Study
. 1990 Summer;11(4):103-19.

Comparing case-mix systems for nursing home payment

B E Fries  1
Affiliations
Comparative Study

Comparing case-mix systems for nursing home payment

B E Fries. Health Care Financ Rev. 1990 Summer.

Abstract

Case-mix systems for nursing homes use resident characteristics to predict the relative use of resources. Seven systems are compared in structure, accuracy in explaining resource use, group homogeneity, and ability to identify residents receiving heavy care. Resource utilization groups, version II (RUG-II), was almost uniformly the best system, although management minutes and the Minnesota case-mix system were also highly effective. Relative weights for case-mix groups were sensitive to cost differences and should be recomputed for new applications. Multiple criteria should be used in choosing a case-mix system, including consideration of inherent incentives and how residents' characteristics are defined.

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Figures

Figure 1
Figure 1. Minnesota classification case-mix system for nursing home residents
Figure 2
Figure 2. Percent of variance explanation of nursing time for selected classification case-mix systems for nursing homes, by data base
Figure 3
Figure 3. Percent of variance explanation of nursing time for selected index case-mix systems for nursing homes, by data base
Figure 4
Figure 4. Percent of variance explanation of nursing cost for selected classification case-mix systems for nursing homes, by data base
Figure 5
Figure 5. Percent of variance explanation of nursing cost for selected index case-mix systems for nursing homes, by data base
Figure 6
Figure 6. Percent of variance explanation of total cost for selected classification case-mix systems for nursing homes in New York State and Medicare data bases
Figure 7
Figure 7. Percent of variance explanation of total cost for selected index case-mix systems for nursing homes in New York State and Medicare data bases
Figure 8
Figure 8. Percent of variance explanation of nursing cost for nursing home residents in the top quartile of nursing costs for selected case-mix systems, by data bases
Figure 9
Figure 9. Normalized measures of nursing time, nursing cost, and total cost for nursing home residents in New York State data base, by normalized case-mix index used in Minnesota system
Figure 10
Figure 10. Normalized measures of nursing time and nursing cost for nursing home residents in Texas data base, by normalized case-mix index used in resource utilization groups, version II (RUG-II)
See this image and copyright information in PMC

References

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