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标题：Integrated care network for long term care in Portugal: cost estimation and patient’s characteristics
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作者：Rui Santana ; Bruno Moita ; Ana Marques 等
期刊名称：International Journal of Integrated Care
电子版ISSN：1568-4156
出版年度：2016
卷号：16
期号：6
DOI：10.5334/ijic.3010
出版社：Utrecht University, Maastricht University, Groningen University
摘要：Background : Portugal began the implementation of an integrated care network for Long Term Care (LTCIN) in 2006. Its main objective is to deliver services of health and social support including post-acute and long term care. There are four different types of inpatient LTC units: Palliative Care Units (PCU), Convalescent Care Units (CCU), Medium Stay and Rehabilitation Care Units (MSRCU) and Long-Stay and Maintenance Care Units (LSMCU) (1). These units are financed both by the Ministry of Health and the Ministry of Social Affairs. In 2014 LTC represented roughly 0.1% of Portuguese GDP. Despite the rapid growth verified (in 2014 the available beds were ten times higher than in 2006), LTC resource allocation was still far from 1% of GDP verified in developed countries such as Australia, UK or Germany (2, 3, 4). The growing demand for LTC, the increase need of public funding, budget constraints and fourth age demographic pressure triggered the need for rethinking the structure of care provision (5). The knowledge of analytical costs per episode and the specific factors that influence cost variation is a relevant issue to the development of alternative ways for resource allocation. Purpose : The main objective of this study was to estimate LTC episode costs and assess their association to patient characteristics and inpatient unit types. Methods : A cross sectional retrospective study was conducted. Data was collected from LTCIN information system including administrative inpatient data (gender and age), physical autonomy and cognitive status of patients from 2010 to 2012. Cost Information (Balance Sheets and Profit and Loss Statement) was provided voluntarily by seventeen LTC providers. To meet the purpose of the analysis we included inpatient episodes only and excluded palliative care units due to organizational issues. Submitted financial data allowed the estimation of costs of 1.856 distinct episodes, roughly 4.1% of all inpatient LTC episodes reported within the timeframe. A top-down cost accounting method was adopted and average per diem cost was estimated for each provider. Each episode cost was achieved multiplying the per diem cost by the LOS of the specific episode.
关键词：long-tem care ; cost estimation