Case Mix, Costs, and Outcomes: Differences Between Faculty and Community Services in a University Hospital

Alan M. Garber, Victor R. Fuchs, James F. Silverman

NBER Working Paper No. 1159 (Also Reprint No. r0510)
Issued in June 1983
NBER Program(s):Health Economics Program

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.

download in pdf format
   (271 K)

email paper

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w1159

Published: Garber, Alan M., Victor R. Fuchs and James F. Silverman. "Aase Mix, Costs , and Outcomes: Differences Between Faculty and Community Services in a University Hospital." The New England Journal of Medicine, Vol. 310, No. 19 (May 10, 1984), pp. 1231-1237

Users who downloaded this paper also downloaded* these:
Salkever and Steinwachs w2010 Hospital Admissions, Length of Stay, and Case-Mix Impacts of Per Case Payment: The Maryland Experience
Becker Investment in Human Capital: Effects on Earnings
Sloan, Picone, Taylor, Jr., and Chou w6706 Hospital Ownership and Cost and Quality of Care: Is There a Dime's Worth of Difference?
Allen, Qian, Zhang, and Zhao w17828 China's Financial System: Opportunities and Challenges
Taylor h0096 Latifundia as Malefactor in Economic Development? Scale, Tenancy, and Agriculture on the Pampas, 1880-1914
NBER Videos

National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email:

Contact Us