| 摘要 |
Health care services are made more efficient by comparing health care services from different providers independently of the clinical complexity of treating the diseases of the patients involved. This is accomplished with a computer-aided system using outpatient and inpatient claims data bases containing indicators of clinical conditions, such as age, gender, diagnoses, and procedures used, and including comparison criteria such as utilizations and indicia of quality. The diseases of the patients of the population are grouped by clinical complexity, and the extent of the systematic relationships between the clinical complexity groups and the comparison criteria are analyzed, preferably by regression analysis. With the extent of the systematic relationships to clinical complexity being known, the health care services of different providers are compared for utilization of procedures and indicia of quality, independently of the differing clinical complexity of the patients receiving the services. The health care services rendered are then modified to improve their efficiency, based on the information revealed in the comparisons. |
