Title

Computer Simulation Model To Evaluate Management Strategies To Face Medicare'S Prospective Payment System.

Abstract

The Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 limits Medicare's reimbursement per patient to a fixed amount depending on the patient's particular type of disease. The reimbursement is based on a set of diagnosis-related groups (DRGs), which categorizes patients into disease classifications. As a result, hospitals must make efficiency gains and managers must look for new ways to provide quality care while containing cost. A simulation model was developed to evaluate the financial effects of particular administrative policies. Patient billing data were collected over a three-month period and analyzed for the purpose of simulating length of stay and resource consumption per cost center. Regression analyses were used to approximate departmental cost as a function of length of stay and to estimate total cost as a function of certain departmental costs. Distribution-fitting techniques were used to determine the method of random generation for independent variables. Two runs are presented to illustrate how policies are simulated and results interpreted.

Publication Date

12-1-1985

Publication Title

Proceedings - Annual Symposium on Computer Applications in Medical Care

Number of Pages

901-905

Document Type

Article; Proceedings Paper

Personal Identifier

scopus

Socpus ID

0022307349 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/0022307349

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