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: In Figure 9, the distribution of severity of illness within DRG's in several different types of hospitals is shown. Each hospital is represented by a stacked bar. Within each bar, the various shaded sub-bars represent the percent of DRG's having one severity of illness level (homogeneous with respect to severity of illness), having two severity of illness levels, etc. In hospital UT1, 18 percent of the DRG's were homogeneous with respect to severity of illness. On the other hand, more than 60 percent of the DRG's in hospital C1 had one level of severity, and fewer than 10 percent of the DRG's had three and four levels of severity. Thus, different hospitals have different numbers of DRG's with a spread of severity of illness.