A comprehensive payment model for short- and long-stay psychiatric patients

TitleA comprehensive payment model for short- and long-stay psychiatric patients
Publication TypeJournal Article
Year of Publication1993
AuthorsFries B.E, Durance P.W, Nerenz D.R, Ashcraft M.L
JournalHealth Care Financing Review
Volume15
Issue2
Pagination31-50
Date PublishedWinter
Accession Number10135343
Keywords*Hospitals, Veterans/ec [Economics], *Insurance, Health, Reimbursement/sn [Statistics & Numerical Data], *Mental Disorders/cl [Classification], *Psychiatric Department, Hospital/ec [Economics], Acute Disease/cl [Classification], Acute Disease/ec [Economics], Diagnosis-Related Groups/cl [Classification], Diagnosis-Related Groups/ec [Economics], Episode of Care, Health Services Research, Hospital Costs/sn [Statistics & Numerical Data], Human, Length of Stay/ec [Economics], Length of Stay/sn [Statistics & Numerical Data], Long-Term Care/cl [Classification], Long-Term Care/ec [Economics], Mental Disorders/ec [Economics], Models, Statistical, Rate Setting and Review/mt [Methods], Support, Non-U.S. Gov't, Support, U.S. Gov't, Non-P.H.S., United States, United States Department of Veterans Affairs
Abstract

In this article, a payment model is developed for a hospital system with both acute- and chronic-stay psychiatric patients. "Transition pricing" provides a balance between the incentives of an episode-based system and the necessity of per diem long-term payments. Payment is dependent on two new psychiatric resident classification systems for short- and long-term stays. Data on per diem cost of inpatient care, by day of stay, was computed from a sample of 2,968 patients from 100 psychiatric units in 51 Department of Veterans Affairs (VA) Medical Centers. Using a 9-month cohort of all VA psychiatric discharges nationwide (79,337 with non-chronic stays), profits and losses were simulated.

Alternate JournalHealth Care Financ Rev