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Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > Europa Medicophysica 2003 December;39(4) > Europa Medicophysica 2003 December;39(4):205-9



A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

Frequency: Bi-Monthly

ISSN 1973-9087

Online ISSN 1973-9095


Europa Medicophysica 2003 December;39(4):205-9


A new system for the prospective payment of inpatient rehabilitation. A summary of the research project: “Development of an iso-resource classification for the prospective payment of rehabilitation care”

Saitto C. 1, De Bernardini L. 2, Di Benedetto P. 3, Fletzer D. A. 4, Marino C. 1, Mastrilli S. 5, Rubino S. 6

1 Department of Epidemiology, ­ASL ­RME, Rome, Italy
2 Poligest SpA, Rome, Italy
3 Physical ­and Rehabilitation Institute Azienda “Ospedali Riuniti”, ­ASS4, Udine, Italy
4 ASL ­RMD, Rome, Italy
5 IRCCS, S. Lucia Foundation, Rome, Italy
6 Tosinvest Sanità, Rome, Italy

A ­new ­system ­for ­the clas­sifi­ca­tion ­and pay­ment of hos­pi­tal reha­bil­i­ta­tion ­was devel­oped as ­the ­result of ­the Italian Ministry ­for Health ­research pro­ject: “Development of an ­iso-­resource clas­sifi­ca­tion ­for ­the pros­pec­tive pay­ment of reha­bil­i­ta­tion ­care”. We ­used mul­ti­var­i­ate regres­sion anal­y­sis to pre­dict ­mean dai­ly ­costs of ­care ­and we ­were ­able to ­define aver­age effec­tive dura­tion of treat­ment ­and ­time ­trends of func­tion­al ­gain by ­class of impair­ment. We cal­cu­lat­ed reim­burse­ment ­per ­case ­through pro­ce­dures ­which ­take ­into ­account indi­vid­u­al ­patient char­ac­ter­is­tics ­and ­length of ­stay ­but ­weigh dif­fer­ent­ly ­each ­day of ­stay accord­ing to ­its expect­ed func­tion­al ­gain. The reim­burse­ment cor­re­lates close­ly ­with actu­al ­costs ­and com­pares favor­ably ­with cur­rent pay­ment ­rates of ­the Italian National Health System. Although we ­are ­aware of ­the pre­lim­i­nary ­nature of ­our ­results we ­feel we con­vinc­ing­ly dem­on­strat­ed ­that, ­after pre­dict­ing indi­vid­u­al dai­ly ­cost of reha­bil­i­ta­tion ­patients, ­and ­after assess­ing effec­tive dura­tion of ­stay ­and ­trends of func­tion­al ­gain by ­class of impair­ment a reim­burse­ment ­system ­can be ­designed ­which par­allels ­costs, val­ues func­tion­al recov­ery, ­and pen­aliz­es ­both unwar­rant­ed ­cutting ­and unwar­rant­ed pro­long­ing of hos­pi­tal ­stay.

language: English


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