TY  - JOUR
AU  - Garber,Alan M.
AU  - Fuchs,Victor R.
AU  - Silverman,James F.
TI  - Case Mix, Costs, and Outcomes:  Differences Between Faculty and Community Services in a University Hospital
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 1159
PY  - 1984
Y2  - August 1984
UR  - http://www.nber.org/papers/w1159
L1  - http://www.nber.org/papers/w1159.pdf
N1  - Author contact info:
Alan M. Garber
Provost
Harvard University
Massachusetts Hall
Cambridge, MA 02138
Tel: 617/496-5100
Fax: 617/495-8550
E-Mail: alan_garber@harvard.edu

Victor R. Fuchs
796 Cedro Way
Stanford, CA  94305
Tel: 650/326-7639
Fax: 650/328-4163
E-Mail: vfuchs@stanford.edu
AB  - In order to gain insight into the possible consequences of prospective payment for university hospitals, we studied 2,025 admissions to the faculty and community services of a university hospital, measuring differences in case mix, costs, and outcomes. The faculty service case mix was disproportionately weighted toward the more costly diagnoses, but even after adjustment for diagnosis-related groups (DRGs), costs were 11 percent higher on the faculty service. The differential was proportionately greater for diagnostic costs than for routine or treatment costs, and the differential was particularly large (70 percent) for patients with a predicted probability of death (DTHRISK) of .25 or greater.The in-hospital mortality rate was appreciably lower on the faculty service after adjustment for case mix and patient characteristics. The mortality differential between the two services was particularly large for patients in the high death risk category. Comparison of a matched sample of 51 pairs of admissions from the high death risk category confirmed the above results with respect to costs and in-hospital mortality, but follow-up revealed that the mortality rates were equal for the two services at nine months after discharge.
ER  -