One approach to building an HSA data base.

This paper discusses one approach for Health Systems Agencies to focus their information acquisition and analysis activities on subjects which will be most helpful to them in gaining visibility and credibility, while also offering opportunities for identifying and quantifying the most serious problem confronting them--the rapid rise in health care expenditures. Assembling information on health care expenditures will have the additional benefit of allowing the planning agencies to isolate and monitor the possible effects which their actions may have on changes in health care costs. This may become particularly critical in a few years when the Congress and HEW are less patient and more insistent that evidence of clear cost control benefits will have to be produced if the nation is to continue to invest in health planning.

Factors affecting nursing home medical review Implications for program and facility planning.

A system for the Medical Review of nursing home patients has been fully operational in the state of Rhode Island since 1973. This study examines recommendations as to the appropriate level of care required by each of 1,309 skilled nursing patients reviewed during the system's first full year of operation and relates these recommendations to a number of other factors, including patient and facility characteristics. Variables measuring patient medical condition and need for skilled nursing care correlated strongly with level of care recommendations made by the team of professional reviewers.

22. Some successes and failures with long-term care data systems: the Rhode Island experience.

A project by Rhode Island Health Services Research (SEARCH) to develop, adapt, and improve data systems in several Rhode Island long-term care settings includes skilled nursing and intermediate care facilities, two chronic care hospitals, mental health institutions, and home health agencies. A successful medical review system was developed for Medicaid nursing home patients which is now a program funded by the state, as well as a good abstracting system for the two chronic hospitals. Also, steps were taken to correct omissions and inaccuracies found in mental health data used in the Multi-State Information System (MSIS), and to modify a limited management information system used by home health agencies.