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
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
VL - 124
SP - 121
EP - 132
JO - Health Policy
JF - Health Policy
SN - 0168-8510
IS - 2
ER -