Table 3. Comparison of case-mix systems with facility-specific and class-rate systems, by case-mix and resource-use measures: 1985.
| Case-mix
|
Facility-specific
|
Class-rate
|
|||||
|---|---|---|---|---|---|---|---|
| Maryland | Ohio | West Virginia | |||||
| Case-mix and resource-use measures | Colorado | Florida | Texas | Utah | |||
| Sample sizes1 | |||||||
| Number of Medicaid patients | 190 | 282 | 140 | 295 | 194 | 246 | 256 |
| Activities of daily living (ADL) score (0-6)2 | 4.82 | 4.61 | 5.12 | 4.10 | 5.08 | 4.39 | 4.16 |
| H – Significance3 | CTU | CTU | CTU | — | — | — | — |
| L – Significance3 | F | F | — | — | — | — | — |
| Resources-use measures4 | |||||||
| RUG-I resource-use index | 3.21 | 3.06 | 3.27 | 2.91 | 3.28 | 3.10 | 3.01 |
| H – Significance | CU | CU | CTU | — | — | — | — |
| L – Significance | — | F | — | — | — | — | — |
| Maryland case-mix rate | $15.62 | $15.38 | $16.12 | $14.43 | $17.34 | $16.27 | $14.55 |
| H – Significance | CU | CU | CU | — | — | — | — |
| L – Significance | F | F | T | — | — | — | — |
| Ohio case-mix rate | $25.56 | $24.35 | $25.09 | $22.66 | $26.12 | $22.98 | $23.46 |
| H – Significance | CTU | CTU | CTU | — | — | — | — |
| L – Significance | — | — | — | — | — | — | — |
| West Virginia case-mix rate | 13.23 | 13.22 | 13.91 | 12.46 | 14.32 | 12.77 | 12.52 |
| H – Significance | CU | TU | CTU | — | — | — | — |
| L – Significance | F | F | — | — | — | — | — |
| Average-rate ratio | 1.01 | 0.99 | 1.03 | 0.92 | 1.08 | 0.97 | 0.94 |
| H – Significance | CU | CTU | CTU | — | — | — | — |
| L – Significance | F | F | — | — | — | — | — |
The total sample included 1,603 Medicaid patients in 91 urban-profit nursing homes.
The 6 ADLs are bathing, dressing, feeding, toileting, transferring, and mobility.
The significance rows indicate for each case-mix State whether its mean value is higher (H) than or lower (L) than each non-case-mix State's mean, at a significance level of p < 0.10. Each State is represented by its first letter.
The resource-utilization group, version 1 (RUG-I) index is from Fries and Cooney (1985); the Maryland, Ohio, and West Virginia case-mix rates are from the study's simulation model; and the average-rate ratio indicates each patient's resource use (relative to all sample patients) implied by simulated payment rates of the 3 case-mix systems combined. See text for details.
NOTES: CTU is Colorado, Texas, and Utah. TU is Texas and Utah. F is Florida. T is Texas. CU is Colorado and Utah.