Hospital Groups and Case-Mix Measurement for Resource Allocation and Payment

Abstract

In Europe and most developed and developing countries of the world, increasing levels of resources are required to fund health care. This is due to a variety of fundamental causes, including the aging of populations, which leads to increasing per capita use of health care services, the fact that higher per capita income also leads to increasing use of health care services, and technical advances which allow physicians to treat previously unbeatable diseases and conditions. This has increased interest in defining equitable methods for resource allocation and payment for health care services. This chapter focuses on inpatient hospital services, although taking ambulatory care or long-term care (LTC) into account may be equally important over the long-term.