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: An example of these results for one hospital with more than 19,000 cases in 1 year is shown in Figure 5. Patients were placed into DRG's and also classified by severity of illness level and procedure type alone, severity and procedure type within MDC's, and severity and procedure type within DRG's. For each of these three ways to use severity of illness, the result is that the severity of illness groups are more homogeneous than the DRG's alone, as indicated by greater reductions in variance, larger F values, and lower coefficients of variation. The number of groups into which the patients were classified in this hospital for each of the case-mix grouping systems is given in parentheses in the legend.