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Title: Costing system for nursing homes: A Portuguese case Authors:  Ines Lopes - ISCTE - IUL (Portugal) [presenting]
Abdul Suleman - Instituto Universitario de Lisboa ISCTE-IUL BRU Lisboa Portugal (Portugal)
Dalia Nogueira - ISCTE-IUL (Portugal)
Elizabeth Reis - ISCTE-IUL (Portugal)
Abstract: A costing system for nursing homes is developed, based on the initial health evaluation of elderly people on admission. The data reflect the complexity items of the interRAI Long Term Care Facilities (LTCF) assessment form, and comprises $N=387$ individuals institutionalized in six non-profit nursing homes in Portugal. A decomposing of the data in fuzzy clusters gives rise to a hierarchical fuzzy 3-partition: Low, Medium and High complexity. The particular distribution of individuals in this partition subsequently leads them to be indexed by a real number such that the higher the number the higher the complexity of the individual. Next, we solve the inverse problem by means of a linear regression model, which allows us to estimate the complexity of every individual on the basis of his/her initial health assessment. Then, we establish a relation between the current cost and the estimated complexity of individuals using another regression model. We add a second order term to account for the nonlinear effects, and obtain a model with good fit, $R^2_{adj}=0.83$. We validate our model by considering 10 additional cases and find a good association between the estimated cost and the cost currently practiced, $p=0.90$.