DRGs, Costs and Quality of CARE: An Agency Theory Perspective

Forgione, Dana A.; Vermeer, Thomas E.; Surysekar, Krishnamurthy; Wrieden, John A.; Plante, Catherine C.

doi:10.1111/j.0267-4424.2005.00222.x

Cited by 23 publications

(29 citation statements)

References 8 publications

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“…It should be noted that the capitation principle is likely to provide financial incentives that are quite different from other types of cost control and that even have the potential to influence operational and treatment choices (see Forgione et al, 2005). One benefit of DRG adoption, from the viewpoint of the decision‐makers, seemed to be the ability to compare and discuss costs with others:…”

Section: Late Adoption Of the Drg Systemmentioning

confidence: 99%

Analysing the Institutional Logic of Late DRG Adopters

Kantola¹,

Järvinen

2012

Financ Acc Manag

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This study investigates how institutional logics that are prevalent in an organizational field influence change in management accounting. More precisely, we examine the institutional logics of late DRG adopters through which organizations attempt to address the pressures imposed by the institutional field of health care. Specific attention is also paid to the way in which organizations operate at different institutional levels and what kinds of interrelationships exist between these levels. Such developments may at least partially explain why the implementation and adoption of DRG–based accounting systems in Finnish health care took almost twenty years.

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Section: Late Adoption Of the Drg Systemmentioning

confidence: 99%

Analysing the Institutional Logic of Late DRG Adopters

Kantola¹,

Järvinen

2012

Financ Acc Manag

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“…'Payment by Results' (PbR) is a form of activity-based funding, similar to the DRG-based funding of hospitals used in many other countries [12,20]. Under PbR, English NHS hospitals are paid according to the number of cases they treat, at a nationally fixed price per case.…”

Section: Introductionmentioning

confidence: 99%

Activity-based funding for National Health Service hospitals in England: managers’ experience and expectations

Sussex

Farrar

2008

Eur J Health Econ

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Activity-based funding of hospital services has been introduced progressively since 2003 in the National Health Service (NHS) in England, under the name 'Payment by Results' (PbR). It represents a major change from previous funding arrangements based on annual "block" payments for large bundles of services. We interviewed senior local NHS managers about their experience and expectations of the impact of PbR. A high degree of 'NHS solidarity' was apparent, and competition between NHS hospitals was muted. PbR has been introduced against a background of numerous other efficiency incentives, and managers did not detect a further PbR-specific boost to efficiency. No impact on care quality, either positive or negative, is yet evident.

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“…The study used an activity-based costing (ABC) method to calculate the cost of the patient's course [18–22]. The English authors have shown that the chosen hospitals are situated in favourable environments and are good candidates for applying the ABC method used to calculate costs [23].…”

Section: Methodsmentioning

confidence: 99%

Cost of hospital care for HIV/AIDS infected patients in three general reference hospitals in Lubumbashi, DR Congo: prospective cohort study

Tshamba

Kaut

Kyalubile³

et al. 2013

Pan Afr Med J

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IntroductionThis article analyses the composition of healthcare costs for HIV/AIDS infected patients in a country with limited resources and attempts to identify the factors that influence these costs. The aims are to calculate medical care costs, analysing how they vary depending on patients’ income, and to evaluate the factors explaining healthcare consumption.MethodsThis is a prospective cohort study focusing on patients who were admitted to hospital for a short stay between January 2010 and June 2011, before their integration into a specialised program. The patients were selected randomly. Free consent was obtained from all participants. Data were analysed using the SPSS 19.0 software. The significance threshold was set at 5% and the CI (Confidence Interval) at 95%. We used Kruskal-Wallis tests, Fisher's exact test and multiple linear regression.ResultsWe monitored 209 patients. Their average age was 36.37 years (SD: 8.72). The sex ratio was 0.58 and the women patients were generally younger than the male ones (p=0.011). The overall cost of healthcare amounted to $US 41,922. The cost of Antiretroviral Therapy represented 21.6% ($US 9,045). The price of para-clinical examinations represented 46% ($US 19,136) of the overall cost. The patient's average monthly income was $US 157.40 whereas the average direct cost per patient was$US 201.45. Both monthly income (t=4.385; p=0.0000) and education level (t=3.703 p=0.0003) were statistically significant predictive factors for healthcare consumption. The medical care costs for patients with opportunistic infections were nine times higher than those for patients who presented none. The presence of opportunistic infections increased healthcare consumption by approximately 31$ US (CI 95%: 15-46.9).ConclusionThe average direct cost for patients on each short-term stay was higher than the average monthly income. To be able to access the necessary services, the patients need additional resources, which are derived from various sources. Monthly income and the level of education were both statistically significant predictors for healthcare consumption. The analysis allows us to extend the study by using different analytical accounting approaches such as by case and by pathology.

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DRGs, Costs and Quality of CARE: An Agency Theory Perspective

Cited by 23 publications

References 8 publications

Analysing the Institutional Logic of Late DRG Adopters

Analysing the Institutional Logic of Late DRG Adopters

Activity-based funding for National Health Service hospitals in England: managers’ experience and expectations

Cost of hospital care for HIV/AIDS infected patients in three general reference hospitals in Lubumbashi, DR Congo: prospective cohort study

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