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Use of specialty psychiatric settings in constructing DRGs
C A Taube1, H H Goldman, E S Lee
1Division of Biometry and Applied Sciences, National Institute of Mental Health, Rockville, Md.
Archives of General Psychiatry
|November 1, 1988
Summary
Psychiatric setting characteristics like staffing intensity and service scope offer minor improvements in predicting patient length of stay beyond patient factors. This finding has implications for healthcare payment systems.
Area of Science:
- Health Services Research
- Psychiatric Care Management
Background:
- Patient descriptors alone explain significant variation in psychiatric length of stay.
- The impact of facility-level characteristics on length of stay requires further investigation.
Purpose of the Study:
- To determine if psychiatric setting characteristics improve length of stay prediction.
- To assess the added value of staffing intensity and scope of services in explaining length of stay variation.
Main Methods:
- Analysis of psychiatric admissions data.
- Comparison of predictive models with and without facility-level characteristics.
- Focus on short-stay admissions (less than 31 days).
Main Results:
- Facility characteristics provided only a small improvement in predicting length of stay.
- Patient descriptors remained the primary predictors of length of stay.
- The predictive power of setting characteristics was limited, especially for short stays.
Conclusions:
- Staffing intensity and scope of services have minimal impact on explaining length of stay variation beyond patient factors.
- Current prospective payment systems may not significantly benefit from incorporating these specific setting characteristics.
- Further research may explore other facility-level factors or different patient populations.