Affordable Access

Are English treatment centres treating less complex patients?

Authors
Publisher
Elsevier Ireland Ltd
Publication Date
Volume
94
Issue
2
Identifiers
DOI: 10.1016/j.healthpol.2009.09.013
Keywords
  • Hospitals
  • Special
  • Reimbursement Mechanisms
  • Prospective Payment System
  • Diagnosis-Related Groups
Disciplines
  • Medicine

Abstract

Abstract Activity-based funding involves remunerating healthcare providers a fixed price per patient in each payment category. However, no categorisation system can account perfectly for differences in patient complexity. Differences may be systematic if providers routinely attract high-risk patients or engage in patient selection. Such differences may be evident in the English National Health Service (NHS) following the introduction of treatment centres that concentrate on providing a small number of high-volume procedures. We analyse data for more than 3.3 million patients to assess whether the complexity of those treated in hospitals and treatment centres differs within twenty-nine payment categories, defined by Healthcare Resource Groups (HRGs). We find that patients treated in hospitals were more likely to come from more deprived areas, to have more diagnoses and to undergo significantly more procedures than patients seen by treatment centres, suggesting that hospitals are treating more complex cases. If these observed differences between hospitals and treatment centres drive costs, then payments should be refined to ensure fair reimbursement.

There are no comments yet on this publication. Be the first to share your thoughts.

Statistics

Seen <100 times
0 Comments

More articles like this

Private sector treatment centres are treating less...

on Journal of the Royal Society o... Aug 01, 2010

Treating more patients in less time.

on Journal of the American Podiat... October 1970

Endovascular treatment for complex intracranial an...

on The neuroradiology journal September 2010
More articles like this..