The Severity of Illness Index as a severity adjustment to diagnosis-related groups.
Bottom Line: Comparative analyses of the resulting case-mix groups within hospitals, and an application of severity-adjusted diagnosis-related groups case-mix definitions.Cross-hospital comparisons.Some of the consequences of incorporating a patient severity refinement into the prospective payment system.
This article discusses the Severity of Illness case-mix groups, and suggests a refinement to diagnosis-related groups (DRG's) designed to accommodate the important element of patient severity. An application of the suggested refinement is presented in a discussion of the efficient production of hospital services. The following areas are addressed. A brief summary of the goals and development of the Severity of Illness Index, and the methodology used to collect severity of illness data on hospital inpatients. Comparative analyses of the resulting case-mix groups within hospitals, and an application of severity-adjusted diagnosis-related groups case-mix definitions. The contribution of the variation in physician practice patterns to the variation in resource use per patient within a hospital. Cross-hospital comparisons. Some of the consequences of incorporating a patient severity refinement into the prospective payment system.
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Mentions: Analysis of variance F test statistics for the Severity of Illness Index and for DRG's are shown in Figure 4. The analysis of variance F test indicates how different the means are between the various groups, compared with the variability within the groups. A higher F value indicates a grouping system with greater differentiation among the groups as well as better homogeneity within the groups. We see that the severity of illness groups have much higher F values than the DRG's. Thus, by three common measures of homogeneity, the severity of illness groups, even though almost always fewer in number, are found to be more homogeneous with respect to resource use than DRG's. These results are representative and typical of those seen from all the hospitals collecting severity of illness data on an ongoing basis.