Case Mix, Costs, and Outcomes

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Abstract
To gain insight into the possible consequences of prospective payment for university hospitals, we studied 2025 admissions to the faculty and community services of a university hospital, measuring differences in case mix, costs, and mortality in the hospital. The faculty service had more of the patients with costly diagnoses, but even after adjustment for diagnosis-related groups (DRGs), costs were 11 per cent higher on the faculty service (95 per cent confidence limits, 4 to 18 per cent). The percentage differential was greatest for diagnostic costs. The differential was particularly large — 70 per cent (95 per cent confidence limits, 33 to 107 per cent) — for patients with a predicted probability of death of 0.25 or greater.

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