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Casemix Classification Payment for Sub-Acute and Non-Acute Inpatient Care, Thailand

Orathai Khiaocharoen BN, MEd*, Supasit Pannarunothai MD, PhD**, Chairoj Zungsontiporn MD***, Wachara Riewpaiboon MD****

Affiliation : * Health Systems and Policy Programme, Faculty of Medicine, Naresuan University, Pitsanuloke, Thailand ** Centre for Health Equity Monitoring, Faculty of Medicine, Naresuan University, Pitsanuloke, Thailand *** Central Office for Healthcare Information, Bangkok, Thailand **** Sirindhorn National Medical Rehabilitation Center, Bangkok, Thailand

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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JMed Assoc Thai
MEDICAL ASSOCIATION OF THAILAND
ISSN: 0125-2208 (Print),
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