Health Services > Collaboration
with the Health Care
Agency, Emilia-Romagna Region, Italy > Risk Adjustment
and Population Based Financing of Health Care
Risk Adjustment and Population Based Financing
of Health Care
For further information contact: Elaine.Yuen@jefferson.edu
Italian law mandates that healthcare funds should be directed at the
local level and allocated according to the National Health Service (NHS)
values of equity and solidarity. Consistent with these values, Center
researchers have designed an approach to developing budgets for health
districts in the Regione Emilia-Romagna that captures the healthcare
needs of the local population to enable a fair allocation of budgets
across districts. The first round of risk adjusters predicts future hospital
and pharmacy costs for each individual based on clinical information
from inpatient and outpatient hospital episodes, prescription drug files,
and demographic data. The risk adjuster assigns individuals into clinical
groupings designed by Center researchers to predict high resource use:
Disease Staging Groups, Chronic Condition Drug Groups, and Body System-Etiology
Groups. A dditional work will include (1) refining the risk adjuster
to capture clinical information from ambulatory data, specialty data,
and clinical data from several prior years; and (2) developing risk adjusters
for other healthcare costs, including ambulatory, specialty, and home
care.
- Yuen EJ, Louis DZ, DiLoreto P, Gonnella JS. Modeling risk-adjusted
capitation rates for regione Umbria (Italy). European Journal
of Health Economics, 4 (4)! 304-312, December 2003.
- Smith KD, Yuen EJ, Donatini A, Louis DZ, Rabinowitz C, Maio V, Jimbo M, Taroni F. Risk Adjustment in a Non-Market-Based-System: The Case of Emilia Romagna, Italy. International Journal of Healthcare Technology and Management, 7 (1-2):100-116, 2005.
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