The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress

C. Saitto, L. De Bernardini, D. A. Fletzer, A. Giustini, A. M. Littera, F. Mastrilli, I. Mastrobuono, M. Traballesi, P. Di Benedetto

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Prospective payment of inpatient rehabilitation services has been suggested or implemented in several countries. The current Italian system classifies patients into 5 broad groups based on MDCs. MDCs are the parent partition of the DRG classification and are meaningless in the rehabilitation setting, a specific classification of inpatient rehabilitation care is thus obviously needed. The fundamental goal of an isoresource classification is building clinically homogeneous discharge groups with the smallest possible within-the-group resource consumption variability. Existing models of patient assessment and classification are presented and their strengths and shortcomings are discussed. The basic characteristics of a satisfactory model are defined and methods of model building are briefly described. No assessment tool looks completely satisfactory, but to accept a limited set of information means accepting the variable selection and the association methods of existing classifications. The selection of variables and the attribution of variable weights in the classification system must be a verifiable end point and not the starting point of analysis. A relationship between explanatory variables and outcome must be sought, not only as a tool to organize and group the costs of the observed events, like CART, but also as an instrument to foresee the reasonable costs of the events to come. Several grouping methods must then be tested and compared against CART (Correlation And Regression Trees), like Search Partition Analysis (SPAN), main components analysis, cluster analysis, multivariate analysis. The objectives of our research are a manageable assessment tool where only positively tested information will be retained and a classification system which could be considered an intelligible and equitable "iso-resource" classification system.

Original languageEnglish
Pages (from-to)129-134
Number of pages6
JournalEuropa Medicophysica
Volume37
Issue number3
Publication statusPublished - 2001

Fingerprint

Rehabilitation
Research
Inpatients
Costs and Cost Analysis
Diagnosis-Related Groups
Cluster Analysis
Multivariate Analysis
Weights and Measures

Keywords

  • Hospital costs
  • Legislation, hospital
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Saitto, C., De Bernardini, L., Fletzer, D. A., Giustini, A., Littera, A. M., Mastrilli, F., ... Di Benedetto, P. (2001). The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress. Europa Medicophysica, 37(3), 129-134.

The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress. / Saitto, C.; De Bernardini, L.; Fletzer, D. A.; Giustini, A.; Littera, A. M.; Mastrilli, F.; Mastrobuono, I.; Traballesi, M.; Di Benedetto, P.

In: Europa Medicophysica, Vol. 37, No. 3, 2001, p. 129-134.

Research output: Contribution to journalArticle

Saitto, C, De Bernardini, L, Fletzer, DA, Giustini, A, Littera, AM, Mastrilli, F, Mastrobuono, I, Traballesi, M & Di Benedetto, P 2001, 'The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress', Europa Medicophysica, vol. 37, no. 3, pp. 129-134.
Saitto C, De Bernardini L, Fletzer DA, Giustini A, Littera AM, Mastrilli F et al. The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress. Europa Medicophysica. 2001;37(3):129-134.
Saitto, C. ; De Bernardini, L. ; Fletzer, D. A. ; Giustini, A. ; Littera, A. M. ; Mastrilli, F. ; Mastrobuono, I. ; Traballesi, M. ; Di Benedetto, P. / The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress. In: Europa Medicophysica. 2001 ; Vol. 37, No. 3. pp. 129-134.
@article{266366a6010c492abc8685ef62aaa156,
title = "The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress",
abstract = "Prospective payment of inpatient rehabilitation services has been suggested or implemented in several countries. The current Italian system classifies patients into 5 broad groups based on MDCs. MDCs are the parent partition of the DRG classification and are meaningless in the rehabilitation setting, a specific classification of inpatient rehabilitation care is thus obviously needed. The fundamental goal of an isoresource classification is building clinically homogeneous discharge groups with the smallest possible within-the-group resource consumption variability. Existing models of patient assessment and classification are presented and their strengths and shortcomings are discussed. The basic characteristics of a satisfactory model are defined and methods of model building are briefly described. No assessment tool looks completely satisfactory, but to accept a limited set of information means accepting the variable selection and the association methods of existing classifications. The selection of variables and the attribution of variable weights in the classification system must be a verifiable end point and not the starting point of analysis. A relationship between explanatory variables and outcome must be sought, not only as a tool to organize and group the costs of the observed events, like CART, but also as an instrument to foresee the reasonable costs of the events to come. Several grouping methods must then be tested and compared against CART (Correlation And Regression Trees), like Search Partition Analysis (SPAN), main components analysis, cluster analysis, multivariate analysis. The objectives of our research are a manageable assessment tool where only positively tested information will be retained and a classification system which could be considered an intelligible and equitable {"}iso-resource{"} classification system.",
keywords = "Hospital costs, Legislation, hospital, Rehabilitation",
author = "C. Saitto and {De Bernardini}, L. and Fletzer, {D. A.} and A. Giustini and Littera, {A. M.} and F. Mastrilli and I. Mastrobuono and M. Traballesi and {Di Benedetto}, P.",
year = "2001",
language = "English",
volume = "37",
pages = "129--134",
journal = "Europa Medicophysica",
issn = "0014-2573",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "3",

}

TY - JOUR

T1 - The Italian research project for the prospective payment of hospital rehabilitation care notes on a work in progress

AU - Saitto, C.

AU - De Bernardini, L.

AU - Fletzer, D. A.

AU - Giustini, A.

AU - Littera, A. M.

AU - Mastrilli, F.

AU - Mastrobuono, I.

AU - Traballesi, M.

AU - Di Benedetto, P.

PY - 2001

Y1 - 2001

N2 - Prospective payment of inpatient rehabilitation services has been suggested or implemented in several countries. The current Italian system classifies patients into 5 broad groups based on MDCs. MDCs are the parent partition of the DRG classification and are meaningless in the rehabilitation setting, a specific classification of inpatient rehabilitation care is thus obviously needed. The fundamental goal of an isoresource classification is building clinically homogeneous discharge groups with the smallest possible within-the-group resource consumption variability. Existing models of patient assessment and classification are presented and their strengths and shortcomings are discussed. The basic characteristics of a satisfactory model are defined and methods of model building are briefly described. No assessment tool looks completely satisfactory, but to accept a limited set of information means accepting the variable selection and the association methods of existing classifications. The selection of variables and the attribution of variable weights in the classification system must be a verifiable end point and not the starting point of analysis. A relationship between explanatory variables and outcome must be sought, not only as a tool to organize and group the costs of the observed events, like CART, but also as an instrument to foresee the reasonable costs of the events to come. Several grouping methods must then be tested and compared against CART (Correlation And Regression Trees), like Search Partition Analysis (SPAN), main components analysis, cluster analysis, multivariate analysis. The objectives of our research are a manageable assessment tool where only positively tested information will be retained and a classification system which could be considered an intelligible and equitable "iso-resource" classification system.

AB - Prospective payment of inpatient rehabilitation services has been suggested or implemented in several countries. The current Italian system classifies patients into 5 broad groups based on MDCs. MDCs are the parent partition of the DRG classification and are meaningless in the rehabilitation setting, a specific classification of inpatient rehabilitation care is thus obviously needed. The fundamental goal of an isoresource classification is building clinically homogeneous discharge groups with the smallest possible within-the-group resource consumption variability. Existing models of patient assessment and classification are presented and their strengths and shortcomings are discussed. The basic characteristics of a satisfactory model are defined and methods of model building are briefly described. No assessment tool looks completely satisfactory, but to accept a limited set of information means accepting the variable selection and the association methods of existing classifications. The selection of variables and the attribution of variable weights in the classification system must be a verifiable end point and not the starting point of analysis. A relationship between explanatory variables and outcome must be sought, not only as a tool to organize and group the costs of the observed events, like CART, but also as an instrument to foresee the reasonable costs of the events to come. Several grouping methods must then be tested and compared against CART (Correlation And Regression Trees), like Search Partition Analysis (SPAN), main components analysis, cluster analysis, multivariate analysis. The objectives of our research are a manageable assessment tool where only positively tested information will be retained and a classification system which could be considered an intelligible and equitable "iso-resource" classification system.

KW - Hospital costs

KW - Legislation, hospital

KW - Rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=0035213083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035213083&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0035213083

VL - 37

SP - 129

EP - 134

JO - Europa Medicophysica

JF - Europa Medicophysica

SN - 0014-2573

IS - 3

ER -