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. 1987 Dec;Spec No(Suppl):17-27.

Medicare elective surgery outcomes and state prospective reimbursement programs

G L Gaumer, E Poggio, C Sennett

Medicare elective surgery outcomes and state prospective reimbursement programs

G L Gaumer et al. Health Care Financ Rev. 1987 Dec.

Abstract

This article examines the relationship between the introduction of State prospective reimbursement (PR) programs and mortality rates for elective surgery. We study 15 such programs using a sample of about 40 percent of U.S. hospitals. We examine mortality data for 1974 to 1983 for these hospitals, selecting a 20-percent sample of all Medicare admissions for eight elective procedures. Indirect standardization (age, sex, procedure) was used to define mortality outcomes, and regression procedures were used to estimate PR effects that controlled for hospital, community, and other regulatory influences. Introduction of PR is found to be occasionally and inconsistently associated with increases in relative mortality.

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Figures

Figure 1
Figure 1. Standardized and actual mortality rate trends for elective surgery, 30 days from admission, in States under prospective reimbursement and States not under prospective reimbursement: 1974-83
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References

    1. Applied Management Sciences. Analysis of Prospective Reimbursement Systems: Western Pennsylvania. Silver Spring, Md.; 1976.
    1. Coelen C, Mennemeyer S, Kidder D. Effects of Prospective Reimbursement Programs on Hospital Revenue, Expense and Financial Status. Cambridge, Mass.: Abt Associates, Inc.; Dec. 1986. HCFA Contract No. 500-78-0036. Prepared for the Health Care Financing Administration.
    1. Cromwell J, Hamilton D, Coelen C, et al. Analysis of Prospective Reimbursement Systems for Upstate New York. Abt Associates Inc.; Cambridge, Mass.: Oct. 1976. DHEW Contract HEW-0S-74-261.
    1. Dowling W, et al. Evaluation of Blue Cross and Medicaid Prospective Reimbursement Systems in Downstate New York. University of Washington; Seattle, Wash.: 1976. DHEW Contract HEW-OS-74-248.
    1. Gaumer G, Poggio E, Coelen C, et al. Effects of Prospective Reimbursement Programs on Patient Care, Final Report. Cambridge, Mass.: Abt Associates Inc.; Mar. 1987. HCFA Contract 500-78-0036. Prepared for the Health Care Financing Administration.

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