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Acute physiology and chronic health evaluation (APACHE II) and Medicare reimbursement.

Wagner DP, Draper EA - Health Care Financ Rev (1984)

Bottom Line: The APS is defined by a relative value scale applied to 12 objective physiologic variables routinely measured on most hospitalized patients shortly after hospital admission.For intensive care patients, APS at admission is strongly related to subsequent resource costs of intensive care for 5,790 consecutive admissions to 13 large hospitals, across and within diagnoses.The APS could also be used to evaluate quality of care, medical technology, and the response to changing financial incentives.

View Article: PubMed Central - PubMed

ABSTRACT
This article describes the potential for the acute physiology score (APS) of acute physiology and chronic health evaluation (APACHE) II, to be used as a severity adjustment to diagnosis-related groups (DRG's) or other diagnostic classifications. The APS is defined by a relative value scale applied to 12 objective physiologic variables routinely measured on most hospitalized patients shortly after hospital admission. For intensive care patients, APS at admission is strongly related to subsequent resource costs of intensive care for 5,790 consecutive admissions to 13 large hospitals, across and within diagnoses. The APS could also be used to evaluate quality of care, medical technology, and the response to changing financial incentives.

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Therapeutic intervention scoring system (TISS) distribution
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Related In: Results  -  Collection


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f2-hcfr-84-supp-091: Therapeutic intervention scoring system (TISS) distribution

Mentions: In this analysis, TISS was measured each day on every patient, and each patient's total TISS over the entire length of the ICU stay was summed. The aggregate mean was 90.0 with a standard deviation of 156.8. The aggregate distribution of admissions across resource costs is illustrated in Figure 2. As in any analysis of individual patient costs, a few extraordinarily expensive patients can substantially influence aggregate means. In order to limit the impact of any individual patient on the subsequent analyses, all individual observations were truncated at 350 TISS points which would normally correspond to 10 days of intense ICU care. These extraordinarily expensive patients, who account for 4 percent of all admissions and 16 percent of total costs, remain included in the analysis. Truncating all of the high-cost patients to 350 TISS points reduced the mean to 75.6 and the standard deviation to 85.6.


Acute physiology and chronic health evaluation (APACHE II) and Medicare reimbursement.

Wagner DP, Draper EA - Health Care Financ Rev (1984)

Therapeutic intervention scoring system (TISS) distribution
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4195105&req=5

f2-hcfr-84-supp-091: Therapeutic intervention scoring system (TISS) distribution
Mentions: In this analysis, TISS was measured each day on every patient, and each patient's total TISS over the entire length of the ICU stay was summed. The aggregate mean was 90.0 with a standard deviation of 156.8. The aggregate distribution of admissions across resource costs is illustrated in Figure 2. As in any analysis of individual patient costs, a few extraordinarily expensive patients can substantially influence aggregate means. In order to limit the impact of any individual patient on the subsequent analyses, all individual observations were truncated at 350 TISS points which would normally correspond to 10 days of intense ICU care. These extraordinarily expensive patients, who account for 4 percent of all admissions and 16 percent of total costs, remain included in the analysis. Truncating all of the high-cost patients to 350 TISS points reduced the mean to 75.6 and the standard deviation to 85.6.

Bottom Line: The APS is defined by a relative value scale applied to 12 objective physiologic variables routinely measured on most hospitalized patients shortly after hospital admission.For intensive care patients, APS at admission is strongly related to subsequent resource costs of intensive care for 5,790 consecutive admissions to 13 large hospitals, across and within diagnoses.The APS could also be used to evaluate quality of care, medical technology, and the response to changing financial incentives.

View Article: PubMed Central - PubMed

ABSTRACT
This article describes the potential for the acute physiology score (APS) of acute physiology and chronic health evaluation (APACHE) II, to be used as a severity adjustment to diagnosis-related groups (DRG's) or other diagnostic classifications. The APS is defined by a relative value scale applied to 12 objective physiologic variables routinely measured on most hospitalized patients shortly after hospital admission. For intensive care patients, APS at admission is strongly related to subsequent resource costs of intensive care for 5,790 consecutive admissions to 13 large hospitals, across and within diagnoses. The APS could also be used to evaluate quality of care, medical technology, and the response to changing financial incentives.

Show MeSH