TY - JOUR
T1 - A systematic review of case-mix models for home health care payment
T2 - Making sense of variation
AU - van den Bulck, Anne O. E.
AU - de Korte, Maud H.
AU - Elissen, Arianne M. J.
AU - Metzelthin, Silke F.
AU - Mikkers, Misja C.
AU - Ruwaard, Dirk
N1 - Funding Information:
The authors would like to thank all experts who contributed to this study by providing relevant articles, documents and/or additional information of the case-mix model and/or payment system related to their respective country. The study was supported by research grants from the Dutch Healthcare Authority (NZa) and from home care organization MeanderGroep Zuid-Limburg , the Netherlands. The funding bodies did not play a role in the study design, the writing of the manuscript, or the decision to submit the manuscript for publication. The views expressed are those of the authors and not necessarily those of the Dutch Healthcare Authority (NZa) or MeanderGroep Zuid-Limburg, the Netherlands. Appendix A
Publisher Copyright:
© 2020 The Authors
PY - 2020/2
Y1 - 2020/2
N2 - Background: Case-mix based payment of health care services offers potential to contain expenditure growth and simultaneously support needs-based care provision. However, limited evidence exists on its application in home health care (HHC). Therefore, this study aimed to synthesize available international literature on existing case-mix models for HHC payment.Methods: We performed a systematic review of scientific literature, supplemented with grey literature. We searched for literature using six scientific databases, reference lists, expert consultation, and targeted websites. Data on study design, case-mix model attributes, and conclusions were extracted narratively.Results: Of 3303 references found, 22 scientific studies and 27 grey documents met eligibility criteria. Eight case-mix models for HHC were identified, from the US, Canada, New Zealand, Australia, and Germany. Three countries have implemented a case-mix model as part of a HHC payment system. Different combinations of in total 127 unique case-mix predictors are included across models to predict HHC use. Case-mix models also differ in targeted services, operationalization, and outcome measures and predictive power.Conclusions: Case-mix based payment is not yet widely used within HHC. Multiple varieties were found between HHC case-mix models, and no one best form of a model seems to exist. Even though varieties are partly inevitable due to country-specific contexts, developing a shared vision in case-mix model attributes would be key to achieving efficient, needs-based HHC. (C) 2020 The Authors. Published by Elsevier B.V.
AB - Background: Case-mix based payment of health care services offers potential to contain expenditure growth and simultaneously support needs-based care provision. However, limited evidence exists on its application in home health care (HHC). Therefore, this study aimed to synthesize available international literature on existing case-mix models for HHC payment.Methods: We performed a systematic review of scientific literature, supplemented with grey literature. We searched for literature using six scientific databases, reference lists, expert consultation, and targeted websites. Data on study design, case-mix model attributes, and conclusions were extracted narratively.Results: Of 3303 references found, 22 scientific studies and 27 grey documents met eligibility criteria. Eight case-mix models for HHC were identified, from the US, Canada, New Zealand, Australia, and Germany. Three countries have implemented a case-mix model as part of a HHC payment system. Different combinations of in total 127 unique case-mix predictors are included across models to predict HHC use. Case-mix models also differ in targeted services, operationalization, and outcome measures and predictive power.Conclusions: Case-mix based payment is not yet widely used within HHC. Multiple varieties were found between HHC case-mix models, and no one best form of a model seems to exist. Even though varieties are partly inevitable due to country-specific contexts, developing a shared vision in case-mix model attributes would be key to achieving efficient, needs-based HHC. (C) 2020 The Authors. Published by Elsevier B.V.
KW - Casemix
KW - Home care services
KW - Classification
KW - Prospective payment system
KW - Systematic review
KW - ACCESS
U2 - 10.1016/j.healthpol.2019.12.012
DO - 10.1016/j.healthpol.2019.12.012
M3 - (Systematic) Review article
C2 - 31928858
SN - 0168-8510
VL - 124
SP - 121
EP - 132
JO - Health Policy
JF - Health Policy
IS - 2
ER -