A practical guide to episode groupers for cost-of-illness analysis in health services research

SAGE Open Med. 2019 Mar 29:7:2050312119840200. doi: 10.1177/2050312119840200. eCollection 2019.

Abstract

Despite the prominence of episode groupers for analysis and reimbursement in US payer settings, peer-reviewed articles using episode groupers for cost-of-illness analysis that informs public health research and decision-making are uncommon. This article provides a brief practical guide to episode-based cost analysis and offers some examples of episode grouper products. It is intended for an audience of health services researchers and managers in public health settings who perform or commission cost-of-illness studies with the US healthcare claims fee-for-service data but lack familiarity with episode groupers.

Keywords: Episode of care; costs and cost analysis; health expenditures; health services research; value-based purchasing.

Publication types

  • Review