Implementing Ambulatory Care Case-Mix Measures in the VA: From Theory to Practice

Rosen AK, Ash AS, Rothendler JR, Loveland S. Implementing Ambulatory Care Case-Mix Measures in the VA: From Theory to Practice. Paper presented at: VA HSR&D National Meeting; 1999 Feb 1; Washington, DC.

Objectives: Ambulatory care case-mix measures are currently being used by health care organizations to describe the illness burden of their populations, evaluate the content of ambulatory practic, assess the costs and quality of care, and predict resource utilization. As the VA evolves into an integrated health care delivery system, methods can take account of the unique issues related to ambulatory care and that can classify patients into clinically homogeneous groupings are critical for accurately assessing VA's effectiveness as a managed care organization.Activities: This workshop will discuss the theoretical and operational frameworks useful in constructing population-based ambulatory care case-mix measures with VA administrative data. We will lead a series of presentations that will describe: 1) the importance of using case-mix measures to evaluate health care delivery in VA; 2) the leading case-mix measurement systems, Ambulatory Care Groups (ACGs) and Diagnostic Cost Groups (DCGs) that are currently being used; 3) the data and file requirements necessary for implementing the ACG and DCG software; 4) the special considerations in constructing input and output measures using VA inpatient and outpatient data. Examples of how specific outcome measures were constructed from VA files will be presented by the speakers; however, as this is an interactive workshop, participants are encouraged to bring examples using ambulatory care case-mix measures from their own research studies. Target Audience: This workshop is intended for researchers interested in using administrative databases to evaluate changes in health care delivery using case-mix measurement systems, as well as managers and clinicans who need to use the results of these analyses for evaluating health care delivery.Audience's Assumed Familiarity with the Subject: Some familiarity with the subject of risk adjustment as well as the different VA databases would be helpful but is not required.