J Med Assoc Thai 2010; 93 (7):849

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Casemix Classification Payment for Sub-Acute and Non-Acute Inpatient Care, Thailand
Khiaocharoen O Mail, Pannarunothai S , Zungsontiporn C , Riewpaiboon W

Background: There is a need to develop other casemix classifications, apart from DRG, for sub-acute and non-acute inpatient
care payment mechanism in Thailand.

Objective: To develop a casemix classification for sub-acute and non-acute inpatient service.

Material and Method: The study began with developing a classification system, analyzing cost, assigning payment weights,
and ended with testing the validity of this new casemix system. Coefficient of variation, reduction in variance, linear regression,
and split-half cross-validation were employed.

Results: The casemix for sub-acute and non-acute inpatient services contained 98 groups. Two percent of them had a
coefficient of variation of the cost of higher than 1.5. The reduction in variance of cost after the classification was 32%. Two
classification variables (physical function and the rehabilitation impairment categories) were key determinants of the cost
(adjusted R2 = 0.749, p =.001). Validity results of split-half cross-validation of sub-acute and non-acute inpatient service were
high.

Conclusion: The present study indicated that the casemix for sub-acute and non-acute inpatient services closely predicted the
hospital resource use and should be further developed for payment of the inpatients sub-acute and non-acute phase.

Keywords: Sub-acute and non-acute inpatient services, Rehabilitation, Casemix classification, Payment mechanism

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