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  1. Function-based payment model for inpatient medical rehabilitation : An evaluation.

    Article - En anglais

    Objective 

    To describe the components of a function-based prospective payment model for inpatient medical rehabilitation that parallels diagnosis-related groups (DRGs), to evaluate this model in relation to stakeholder objectives, and to detail the components of a quality of care incentive program that, when combined with this payment model, creates an incentive for providers to maximize functional outcomes.

    Data Sources 

    This article describes a conceptual model, involving no data collection or data synthesis.

    Data Synthesis 

    The basic payment model described parallels DRGs.

    Information on the potential impact of this model on medical rehabilitation is gleaned from the literature evaluating the impact of DRGs.

    The conceptual model described is evaluated against the results of a Delphi Survey of rehabilitation providers, consumers, policymakers, and researchers previously conducted by members of the research team.

    Conclusions 

    The major shortcoming of a function-based prospective payment model for inpatient medical rehabilitation is that it contains no inherent incentive to maximize functional outcomes.

    Linkage of reimbursement to outcomes, however, by withholding a fixed proportion of the standard FRG payment amount, placing that amount in a « quality of care » pool, and distributing that pool annually among providers whose predesignated, facility-level, case-mix-adjusted outcomes are attained, may be one strategy for maximizing outcome goals.

    Mots-clés Pascal : Réhabilitation, Hospitalisation, Economie santé, Evaluation, Etats Unis, Amérique du Nord, Amérique, Traitement, Homme, PMSI, Groupe homogène malade

    Mots-clés Pascal anglais : Rehabilitation, Hospitalization, Health economy, Evaluation, United States, North America, America, Treatment, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0342958

    Code Inist : 002B26O. Création : 10/04/1997.