Do different case-mix measures affect assessments of provider efficiency? Lessons from the Department of Veterans Affairs

Published: July 1, 2003
Category: Bibliography > Papers
Authors: Berlowitz DR, Christiansen CL, Loveland SA, Rakovski CC, Rosen AK
Countries: United States
Language: null
Types: Performance Analysis
Settings: Health Plan, Hospital

J Ambul Care Manage 26:229-242.

Center for Health Quality, Outcomes and Economic Research, Bedford VAMC, Bedford, MA, USA

Although case-mix adjustment is critical for provider profiling, little is known regarding whether different case-mix measures affect assessments of provider efficiency. We examine whether two case-mix measures, Adjusted Clinical Groups (ACGs) and Diagnostic Cost Groups (DCGs), result in different assessments of efficiency across service networks within the Department of Veterans Affairs (VA). Three profiling indicators examine variation in resource use. Although results from the ACGs and DCGs generally agree on which networks have greater or lesser efficiency than average, assessments of individual network efficiency vary depending upon the case-mix measure used. This suggests that caution should be used so that providers are not misclassified based on reported efficiency.

PMID: 12856502

Resource Use Practice Patterns Comparison,Population Markers,United States,Aged,Ambulatory Care/organization & administration,Database Management Systems,Delivery of Health Care,Integrated/utilization,Gender,Health Services Research,Hospitals,Veterans/utilization,Middle Aged,Morbidity,Outcome Assessment (Health Care),Regression Analysis,United States/epidemiology,United States Department of Veterans Affairs

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