Health Telematics (AIM) Final Report


	Updated: Feb 1, 97
CAMIREMA / CAMIREMA-EAST

Concerted Action on Telematics used in Case Mix and Resource Management

Project Code: A2101

Project value: 250 KECU

EC contribution: 250 KECU

No of partners: 41

No of countries: 14

Duration: 40 months

Contact:
Jacob Hofdijk
HISCOM
Schipolweg 97
NL-2316 XA Leiden, The Netherlands
Tel. +31-71-525.67.08
Fax +31-71-521.98.56
E-mail: jacob@bazis.nl

Overview

Classification of treatments of patients, sometimes called Case Mix has been identified as a potential tool for measuring health care delivery. By applying this methodology within patient based information systems the missing link can be established with the resources used. The objective of the CAMIREMA concerted action was to stimulate the process of the exchange of experiences with the case mix methodology to better manage resources in health care. Approximately 20 partners participated in this action which covered three domains- Acute hospital care, primary care/outpatients and tertiary care.

Purpose and objectives

A growing interest in the management of resources used in health services has been observed in recent years. One of the main issues is to link the use of resources to the care delivered to patients in the community. No agreed system of measurements exist to assist managers at different levels in the (vertical) health care market. Classification of treatments of patients, sometimes called Case Mix has been identified as a potential tool for measuring health care delivery. By applying this methodology within patient based information systems the missing link can be established with the resources used. The objective of the CAMIREMA concerted action was to stimulate the process of the exchange of experiences with the case mix methodology to better manage resources in health care. Although health care is organised quite differently in the member states, the CAMIREMA concerted action has identified :

Acute Institutional Care / inpatient and outpatient,
Ambulatory Care / outpatients (non institutional care), Community and Primary care including general practice, and
Chronic and long term institutional care/rehabilitation.
Integration of concepts on care delivery by episode linkage

Special emphasis thus has been given to an integral, holistic view on care delivered to a patient within the health care system, supporting the continuity of care concept. The concertation has been achieved by the organisation of a series of workshops on specific topics. Each year during the international working conference of the network of Patient Classification Systems / Europe a round up on all topics has been arranged. New health telematics tools has been used extensively to stimulate the exchange of information.

Results

The process of concertation has extended the network of experts, researchers , clinicians, politicians and other users in the member states. With the help of the Copernicus program the concertation process has been extended to central and eastern Europe . This has given some more insight in the possible contribution of health care management tools for the reform of health service delivery.

The results of CAMIREMA have been :

the building of a community for the application of case mix in ambulatory care,
the establishment of the CHAINE gang to develop a common understanding of the linking of episodes of care supporting the management of care in the community,
the introduction of the CAMIREMA Handbook,
the establishment of the WWW service for Case Mix and Resource Management,

The Concerted Action has intensified the existing platform for the Research and Development on Case mix and Resource Management. It has also involved Central and Eastern European countries in this process in close collaboration with other European support programs like Copernicus and PHARE.

A questionnaire has been made of case mix and resource management tools actually used and needs for further research in different member states have been identified.

An interesting coincidence is the extension of the use of case mix in the member states during the CAMIREMA years. The concertation process has not created specific products, that could be marketed. However the concerted action has added value to national approaches to case mix and resource management by creating a European network and exchanging information on experiences, draw backs and successes with the implementation of tools of hospital management based on case mix and resource management. A European approach to case mix as proposed by the CAMAC project however is to use clustering methodologies, focused at a specific management objective. For managing the effectiveness of resource use in the care delivery another clustering method is needed, than for allocating resources to hospitals. An important objective of introducing case mix was to be able to apply business management techniques in health care. Future research is needed to apply both methodologies in an integrated fashion. During the CAMIREMA Concerted Action activities have been supported to develop research and development proposals to extend the knowledge and experience in this field. Although no miracles can be forced surprises can't be excluded. A proposal has been made to extend the concertation work on resource management with a special focus on the episode linkage issue. This issue is of great importance for the management of resources in the vertical health care market.

List of Participants

Prof. Francis Roger-France UCL Clinique Universitaire St. Luc Avenue Hippocrate 10 B-1200 Bruxelles, Belgium Tel.: +32-2-764.47.11 Fax: +32-2-764.45.00	Prof. Jos Willems Universitair Ziekenhuis Gasthuisberg Diensthoofd Medische Informatica Herestraat 49 B-3000 Leuven, Belgium Tel.: +32-16-21.38.01 Fax: +32-16-21.37.96
Ms Annie Andjaer-Jensen Danish Hospital Institute Nyropsgade 18 DK-1602 Copenhagen V, Denmark Tel.: +45-33-11.57.77 Fax: +45-33-93.16.36	Dr. H. Bay-Nielsen National Board of Health Amaliegade 13 DK-1012 Copenhagen K, Denmark Tel.: +45-33-91.16.01 Fax: +45-33-93.16.36
Mr. Gunnar Nielsen Danish Institute for Health and Nursing Research Fensmarkgade 3 DK-2200 Copenhagen N, Denmark Tel.: +45-31-39.40.66 Fax: +45-31-39.03.31	Ir. R.G.M. van den Heuvel SIG PO Box 14066 NL-3508 SC Utrecht, The Netherlands Tel.: +31-30-34.51.00 Fax: +31-30-31.31.49
Drs. W.J. Hofdijk BAZIS Schipholweg 97 NL-2316 XA Leiden, The Netherlands Tel.: +31-71-25.67.08 Fax: +31-71-21.66.75	Prof. Dr. Reiner Leidl University of Limburg Department of Health Economics PO Box 616 NL-6200 MD Maastricht, The Netherlands Tel.: +31-43-88.34.39 Fax: +31-43-21.90.80
Prof. Dr. G. Neubauer Universität der Bundeswehr München Werner-Heisenberg-Weg 39 D-8014 Neubiberg, Germany Tel.: +49-89-60.04.42.29 / 42.83 / 42.86 Fax: +49-89-601.46.93	Prof. Dr. E. Knappe University Trier Zentrum für Arbeit und Soziales Postfach 382 D-5500 Trier, Germany
P. Rehermann IFG Institute for Health Economics Nixenweg 2b D-8000 München 5, Germany Tel.: +49-89-60.51.98 Fax: +49-89-60.49.89	Dr. Eamonn O' Shea University College Galway Department of Economics IRL-Galway, Ireland Tel.: +353-91-244.11 Fax: +353-91-241.30
Dr. Miriam Wiley Economic & Social Research Institute Burlington Road IRL-Dublin 4, Ireland Tel.: +353-1-76.01.15 Fax: +353-1-68.62.31	M. André Loth Ministère de la Santé Direction des Hospitaux Mission PMSI 8, Av. de Ségur F-75007 Paris, France Tel.: +33-1-40.56.53.35 Fax: +33-1-40.56.50.45
Dr. F. Mennerat Faculté de Médecine 15, Rue Ambroise Paré F-42100 Saint Etienne, France Tel.: +33-84-35.25.91 Fax: +33-84-24.81.67	Prof. F. Minaire Dépt. de Réeducation Fonctionelle Faculté de Médecine 15, Rue Ambroise Paré F-42100 Saint Etienne, France Tel.: +33-77-42.77.57 Fax: +33-77-42.14.99
Prof. Jean-Marie Rodrigues Univ. de St. Etienne Jean Monnet Santé Publique Chru Hospital St. Jean Bonnefonds 15, Rue Ambroise Paré F-42650 St. Jean Bonnefonds, France Tel.: +33-77-42.79.74 Fax: +33-77-42.79.70	Dr. Gérard de Pouvoirville Ecole Polytechnique Centre de Recherche en Gestion F-75005 Paris, France Tel.: +33-1-46.34.34.29 Fax: +33-1-46.34.34.28
Dr. I. Yfantopoulos Athens University Fidipidou 45-47, Goudi GR-11527 Athens, Greece Tel.: +30-1-778.95.08 Fax: +30-1-778.18.29 / 684.02.12	Mr. Carlo Ramponi SDA Bocconi Via Bocconi 8 I-20136 Milano, Italy Tel.: +39-2-58.36.62.03 Fax: +39-2-58.36.62.17
Mrs Margarida Bentes SIGSS Sistema de Informacao para a Gestao dos Servicos de Saude Av. da Republica 61 P-1000 Lisboa, Portugal Tel.: +351-1-796.30.47 Fax: +351-1-793.19.19	Prof. Antonio Correia de Campos Escola National de Saude Republica Av. Padre Cruz P-1699 Lisboa, Portugal Tel.: +351-1-758.55.99 Fax: +351-1-758.27.54
Mrs Deolinda David SIGSS Sistemas Informacao Gestao Servicos Saude Av. Republica 61 P-1000 Lisboa, Portugal Tel.: +351-1-793.18.72 Fax: +351-1-793.19.19	Mr A. Miraldo Rosa Mota Hospital da Universidad de Coimbra (HUC) Servico de Estatistica Pro. Mota Pinto P-3000 Coimbra, Portugal Tel.: +351-39-72.32.11 Fax: +351-39-239.07
Dr Esteban Carrillo Servei Catala de la Salut Area Sanitaria Travessera de les Corts, 131-159 E-08028 Barcelona, Spain Tel.: +34-3-339.11.11 Fax: +34-3-411.11.14	Mrs Mercè Casas IASIST Rda. Universitat, 23 - 3er 2a B E-08007 Barcelona, Spain Tel.: +34-3-301.40.61 / 301.46.04 Fax: +34-3-317.25.97
Mr David Hughes Department of Social Sciences City University London North-Hampton Square London EC1V OHB, U.K. Tel.: +44-71-477.80.00 Fax: +44-71-477.85.80	Dr Allen Hutchinson University of Newcastle upon Tyne Centre for Health Services Research Ambulatory Care Programme 21 Claremont Place Newcastle upon Tyne NE2 4AA, U.K. Tel.: +44-91-222.70.47 / 60.00 Fax: +44-91-222.60.43
Michael J.Rigby University of Keele Centre for Health Planning and Management Science Park, Keele Staffordshire ST5 5SP, U.K. Tel.: +44-782-62.11.11 Fax: +44-782-71.17.37	Mrs Kate Simons National Casemix Office Wessex Regional Health Authority Dawn House, Sleepers Hill Hants SO22 5DH Winchester, U.K. Tel.: +44-962-86.35.11 Fax: +44-962-85.23.37
Mr John Taylor University College of Wales Institute of Health Informatics Llanbadarn Aberystwyth Dyfeld SY23 3BZ Wales, U.K. Tel.: +44-1970-62.24.37 Fax: +44-1970-62.21.90	Mr. Arun Nanda WHO European Office Scherfigsvej 8 DK-2100 Copenhagen, Denmark Tel.: +45-39-17.12.99 Fax: +45-31-18.11.20
Prof. Mats Brommels University of Helsinki Medical School Haartmaninkatu 3 SF-00290 Helsinki, Finland Tel.: +358-04-34.66.11 Fax: +358-04-34.64.56	Mr Tjorborg Hogsnes Sosial Department Grubbegatan 10 N-0030 Oslo, Norway Tel.: +47-2-37.90.90 Fax: +47-2-34.95.78
Mr Sune Andreasson Scandinavian Health Strategies PO Box 12024 S-40241 Göteborg, Sweden Tel.: +46-31-69.43.15 Fax: +46-31-69.09.50	Prof. Dr. Jordan Jantschulev Centre for Research and Application of Health Insurance System Dimitar Nestorov Blvd. 15 BG-1431 Sofia, Bulgaria Tel.: +35-92-59.80.56 Fax: +35-92-59.31.75
Mr Stanislav Vachek University Hospital Brno Robunice Jihlavska 100 CZ-63900 Brno, Czechoslovakia Tel.: +42-53-208.05 Fax: +42-53-259.44	Mr Pál Ladányi Information Centre for Health Care of the Ministery of Welfare Arany János u. 23-25 H-7102 Szekszárd, Hungary Tel.: +36-74-192.33 Fax: +36-74-167.24
Mr J.Michael Fitzmaurice, Ph.D Department of Health & Human Services Rockville, MD 20852 United States of America Tel.: +1-301-227.84.83 Fax: +1-301-227.82.12	Prof. George Palmer PO Box 1 Kensington New South Wales 2033, Australia Tel.: +61-169-725.93 Fax: +61-266-349.26



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CAMIREMA / CAMIREMA-EAST

Overview

Purpose and objectives

Results

List of Participants