Abstract
This study aimed to develop a new casemix classification system as an alternative method for the budget allocation of oral healthcare service (OHCS). Initially, the International Statistical of Diseases and Related Health Problem, 10th revision, Thai Modification (ICD-10-TM) related to OHCS was used for developing the software “Grouper”. This model was designed to allow the translation of dental procedures into eight-digit codes. Multiple regression analysis was used to analyze the relationship between the factors used for developing the model and the resource consumption. Furthermore, the coefficient of variance, reduction in variance, and relative weight (RW) were applied to test the validity. The results demonstrated that 1,624 OHCS classifications, according to the diagnoses and the procedures performed, showed high homogeneity within groups and heterogeneity between groups. Moreover, the RW of the OHCS could be used to predict and control the production costs. In conclusion, this new OHCS casemix classification has a potential use in a global decision making.
Highlights
IntroductionIn Thailand, health insurance systems are categorized into three major schemes: the Civil Servant Medical Benefit Scheme (CSMBS), the Social Security Scheme (SSS), and the Universal Coverage Scheme (UCS) or the “30 baht (in 2002, 43.0 Baht/US$ copayment) for all diseases” (UCS was implemented in May 2001 and introduced nationwide in April 2002) [1]
There are many insurance systems worldwide for Universal Healthcare Coverage
In Thailand, health insurance systems are categorized into three major schemes: the Civil Servant Medical Benefit Scheme (CSMBS), the Social Security Scheme (SSS), and the Universal Coverage Scheme (UCS) or the “30 baht for all diseases” (UCS was implemented in May 2001 and introduced nationwide in April 2002) [1]
Summary
In Thailand, health insurance systems are categorized into three major schemes: the Civil Servant Medical Benefit Scheme (CSMBS), the Social Security Scheme (SSS), and the Universal Coverage Scheme (UCS) or the “30 baht (in 2002, 43.0 Baht/US$ copayment) for all diseases” (UCS was implemented in May 2001 and introduced nationwide in April 2002) [1]. One key difference between the insurance schemes is that the UCS separated the provider budget between the inpatient and the outpatient for exclusive capitation. Under this paradigm, the outpatient budget was allocated on the basis of the capitation rate, while the inpatient budget was allocated on the basis of Diagnosis Related Group (DRG) within a global budget [1]
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