[EQ] The Cost of Hospital Stays: Why Costs Vary

The Cost of Hospital Stays: Why Costs Vary

 

Canadian Institute for Health Information (CIHI) 2008

 

Available online PDF file [73p.] at: http://secure.cihi.ca/cihiweb/products/2008HospCosts_report_final_Eng_web.pdf

 

“… This looks at the average costs of a wide range of treatments and procedures performed during acute care hospital stays for typical patients, and some of the reasons these costs can vary from patient to patient.

 

The report begins by providing the big picture on how much Canada spends on hospitals and in relation to total health expenditures. It then shows how new tools such as CMG+ can be used to estimate costs of hospital stays. Finally, the report provides insights on how certain factors can affect hospitalization costs for typical cases, such as the presence of other illnesses (beyond the most responsible reason for admission into hospital), the age of a patient, how many interventions are used during a patient's hospital stay, how and where a patient is treated and the type of interventions used….”

 

What Is and Case Mix Groups CMG+?

The CMG+ methodology is used to create distinct patient groupings that are clinically similar and/or homogenous with respect to hospital resources used. By linking patient groups to resources used in their treatment, CMG+ provides a tool for analyzing resource utilization and costs.

The case mix grouping methodology was revised to make use of the most recent Canadian classification systems for diseases and related health problems and interventions.

The CMG+ methodology assigns patient records to major clinical categories (MCCs) and Case Mix Groups (CMGs). Both MCCs and CMGs are based on either a diagnosis or condition described as being most responsible for the patient’s stay in hospital—in clinical terms, the “most responsible diagnosis” (MRDx)—or based on an intervention that significantly affects the pattern of care and resources consumed by a patient.

 

Content:

Executive Summary

1. Overview of Hospital Spending in Canada

Who Pays for Hospital Care?

Where Does the Money Go?

Breaking Down Hospital Spending

2. Measuring Average Acute In-Hospital Costs

What Is CMG+?

What’s New About CMG+: The Five Factors

Using CMG+ and Other Tools to Calculate Average Costs

3. Looking Into Hospital Costs: Selected Examples

Factors Affecting Hospital Costs

Cost of Treating Atypical and Long-Stay Patients

Information Gaps

What We Know

What We Don’t Know

What’s Happening

References

Appendix

 

 

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[EQ] US National Healthcare Disparities Report - 2007

National Healthcare Disparities Report, 2007   U.S. Department of Health and Human Services Agency for Healthcare Research and Quality Rockville, MD - AHRQ Publication No. 08-0040 - February 2008

Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. The reports present, in chart form, the latest available findings on quality of and access to health care. The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations. The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as children and older adults. National Healthcare Disparities Report Available online PDF file [252p.] at: http://www.ahrq.gov/qual/nhdr07/nhdr07.pdf National Healthcare Quality Report (NHQR) Full report available online as PDF file [144p.] at: http://www.ahrq.gov/qual/nhqr07/nhqr07.pdf   Highlights 1. Introduction and Methods 2. Effectiveness. Cancer . Diabetes End Stage Renal Disease (ESRD) Heart Disease HIV and AIDS . Maternal and Child Health Mental Health and Substance Abuse . Respiratory Diseases. Nursing Home, Home Health, and Hospice Care.   3. Patient Safety 4. Timeliness 5. Patient Centeredness 6. Efficiency     Website: http://www.ahrq.gov/qual/qrdr07.htm

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
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[EQ] Measuring Financial Protection in Health

Measuring Financial Protection in Health

Adam Wagstaff

The World Bank - Development Research Group - Human Development and Public Services Team

March 2008 - Policy Research Working Paper 4554

 

Available online as PDF file [34p.] at:
http://www-wds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2008/03/12/000158349_20080312140044/Rendered/PDF/wps4554.pdf

 

“…..Health systems are not just about improving health. Good ones also ensure that people are protected from the financial consequences of illness and death, or at least from the financial consequences associated with the use of medical care. Anecdotal evidence suggests health systems often perform badly in this respect, apparently with devastating consequences for households, especially poor ones and near-poor ones. The World Bank’s 50-country participatory poverty study known as Voices of the Poor1 found that poor health and illness are universally dreaded as a source of destitution, partly because of the costs of health care but also the income lost due to illness.

 

Voices of the Poor documents the case of a 26 year-old Vietnamese man who, as a result of the large health care costs necessitated by his daughter’s severe illness, has moved from being the richest man in his community to being one of the poorest.2 Also recorded was the case of a 30-year-old Indian mother of four who has been forced to sell the family’s home and land, and has to walk 10 kilometers a day transporting wood on her head in order to finance the cost of her diabetic husband’s medical care.2

 

How can one measure the success with which a health system protects people against the financial consequences of ill health? What do systems that do well in this regard have in common? And how far do health system reforms improve people’s financial protection vis-à-vis health expenses?

 

This paper provides an overview of the methods and issues arising in each case, and presents empirical work in the area of financial protection in health, including the impacts of government policy. The paper also eviews a recent critique of the methods used to measure financial protection…….”

 

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
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