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
