Method and apparatus for objectively monitoring and assessing th

Details Method and apparatus for objectively monitoring and assessing th Method and apparatus for objectively monitoring and assessing th

1996-06-04

1998-12-01

MacDonald, Allen R.

Data processing: financial, business practice, management, or co

Automated electrical financial or business practice or...

Health care management

705 3, 705 4, G06F15900, G06F 1700

Patent

active

058452540

ABSTRACT:
A method and apparatus for objectively monitoring the performance of a group of health-care providers. In-patient payment claim records representative of in-patient health-care services performed for patients by health-care providers within the group of health-care providers and out-patient payment claim records representative of out-patient health-care services performed for patients by health-care providers within group of health-care providers are stored in databases. A plurality of sickness episode data records are built from the in-patient payment claim records and the out-patient payment claim records, and an objective severity adjustment analysis is performed on the sickness episode data records to form a plurality of severity-adjusted sickness episode data records. A cost-efficiency performance level is determined for each individual health-care provider within the group of health-care providers from the plurality of severity-adjusted sickness episode data records, and a qualitative performance level is determined for the group of health-care providers as a whole.

REFERENCES:
patent: 5365425 (1994-11-01), Torma et al.
patent: 5508912 (1996-04-01), Schneiderman
patent: 5544044 (1996-08-01), Leatherman
patent: 5557514 (1996-09-01), Seare et al.
patent: 5724379 (1998-03-01), Perkins et al.
Horn, Susan D. "Measuring Severity: How Sick is Sick? How Well is Well?" Healthcare Financial Management, Oct. 1996, pp. 21-31.

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