1. Improving casemix systems by integrating functioning information:
Improving casemix systems by integrating functioning information:
A systematic literature review and call for expert input
Maren Hopfe1,2, Gerold Stucki1,2,3, Mirjam Brach1,2,3, Birgit Prodinger1,2,3
1)Swiss Paraplegic Research, Nottwil, Switzerland
2)Department of Health Sciences & Health Policy, University of Lucerne, Lucerne, Switzerland
3)ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany
(at DIMDI), Nottwil, Switzerland
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2.
Background
Information about a disease and a person’s functioning are complimentary.
Current reimbursement systems, especially casemix systems, still rely predominantly on disease-specific information.
First screening of the literature showed some evidence that functioning information adds value to existing casemix systems, such as Diagnosis Related Groups (DRGs).
Systematic examination of the evidence on the added value of functioning information in casemix systems is needed to inform the decision on whether to adapt current casemix systems.
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3.
Objective
To identify the value of integrating functioning information into casemix systems to improve financing in current health systems.
More specifically, the aims are to
determine indicators of added value of casemix systems based on the existing literature, and
examine potential areas of use for integrating functioning information into casemix systems
Procedures
Diagnosis
Age
Gender
Comorbidities
Functioning
Grouper
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4. Systematic literature review
Methods & Materials
Systematic literature review
Search terms:
Functioning OR “Functional status” OR Function* OR ICF OR “International Classification of Functioning, Disability and Health” OR “Activities of Daily Living” OR ADL
Casemix OR “case mix” OR “Diagnosis Related Groups” OR “Function Related Groups” OR “Resource Utilization Groups” OR “AN-SNAP”
AND
Inclusion criteria for studies:
empirical, with a comparative component
account for functioning information in casemix systems
published in peer-reviewed international journals (English or German language)
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5. Preliminary Results (I)
Preliminary Results (I)
PRISMA Flow chart
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6. Preliminary Results (II)
Preliminary Results (II)
Preliminary grouping of studies
Examining existing systems by adding functioning information
Comparison of two existing casemix systems which include both functioning information
Development of casemix systems including functioning information as essential component
Most common settings
Most common outcome parameters
Acute care hospitals
Inpatient rehabilitation facilities
Long-term care facilities
Nursing homes
Psychiatry
Costs
Length of stay (LOS)
Mortality
Discharge destination
Functional gain
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7. The authors acknowledge the support of Conal Twomey.
Conclusion
Functioning in casemix has been studied since the development of casemix systems.
This review provides a systematic overview on the evidence on the integration of functioning information into casemix systems throughout various settings and along the continuum of care.
The preliminary findings reveal great heterogeneity, including the assessment of functioning, which challenge synthesis of existing evidence and points to the need for standards in collecting and reporting functioning information.
Acknowledgements
The authors acknowledge the support of Conal Twomey.
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8. Thank you for your attention! Comments, thoughts, and questions?
Thank you for your attention!
Comments, thoughts, and questions?
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