Complexity and function. Review of case-mix systems in geriatrics;Complejidad y función. Revisión de los sistemas de clasificación de pacientes en geriatría

Revista Espanola de Geriatria y Gerontologia

Volumn 41, Issue SPEC. ISS. 1, 2006, Pages 50-58

  García Navarro, José Augusto ^a,c   Cedó, Rosa María Tomàs ^b  

^a Departamento de Área Operativa del Grup Sagessa   (Spain)

^b Departamento de Epidemiologia Informacion Y Evaluacion Asistencial del Grup Sagessa   (Spain)

^c HOSPITAL UNIVERSITARI SANT JOAN DE REUS   (Spain)

Author keywords

Case mix systems; Dependence; Diagnosis related groups; Resource utilization groups

Indexed keywords

GERIATRIC CARE; HEALTH CARE SYSTEM; HEALTH SERVICE; HOSPITALIZATION; HUMAN; PATIENT CARE; REVIEW;

EID: 33846186789     PISSN: 0211139X     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0211-139X(06)72999-7     Document Type: Review

References (39)

1. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818-29.
2. Young WW, Swinkola RB, Zorn DM. The measurement of hospital case mix. Med Care. 1982;20:501-12.
3. Gonnella JS, Hornbrook MC, Louis DZ. Staging of disease. A case-mix measurement. J Am Med Assoc. 1984;251:637-44.
4. Maio V, Yuen E, Rabinowitz C, Louis D, Jimbo M, Donatini A. Using pharmacy data to identify those with chronic conditions in Emilia Romagna, Italy. J Health Serv Res Policy. 2005;10:232-8.
5. D'Andrea G, Capalbo G, Volpe M, Marchetti M, Vicentini F, Capelli G. Appropriateness evaluation of hospital admissions using isogravity classification systems APR-DRG and Disease Staging and the Italian version of Appropriateness Evaluation Protocol (AEP). Ann Ig. 2006;18:49-62.
6. Rhodes G, Wiley M, Tomas R, Casas M, Leidl R. Comparing EU hospital efficiency using diagnosis-related groups. Eur J Public Health. 1997;7 Suppl 3:42-50.
7. Wiley MM. Hospital financing reform and case-mix measurement: An international review. H Care Fin Rev. 1992;13:119-33.
8. Casas M, Wiley MM. Diagnosis-Related Groups in Europe. Uses and Perspectives. Berlin: Springer-Verlag; 1993.
9. Salvador X. Revisión de la versión internacional refinada de los GRD en Cataluña. Comunicación a xxv Jornadas Economía de la Salud. Barcelona, 13-15 de julio de 2005. Proceedings.
10. Mullin R, Vertrees J, Freedman R, Castion R, Tinker A. Case-Mix analysis across patient populations and boundaries. A refined classification system designed specifically for international use. Disponible en: http://www.3m.com/ us/healthcare/his/pdf/reports/ir_drg_whitepaper_09_02.pdf
11. Berenson RA, Pawlson LG. The Medicare Prospective Payment System and the care of the frail elderly. J Am Geriatr Soc. 1984;32:843-8.
12. Jencks SF, Kay T. Do frail, disabled, poor, and very old Medicare beneficiaries have higher hospital charges? J Am Med Assoc. 1987;257:198-202.
13. Chuang KH, Covinslcy KE, Sands LP, Fortinsky RH, Palmer RM, Landefeld CS. Diagnosis-related group-adjusted hospital costs are higher in older medical patients with lower functional status. J Am Geriatr Soc. 2003;51:1729-34.
14. Conesa A, Vilardell L, Munoz R, Casanellas JM, Torre P, Gelabert G. Análisis y clasificación de las urgencias hospitalarias usando Ambulatory Patient Groups. Gac Sanit. 2003;17:447-52.
15. Weiner JP, Dobson A, Maxwell SL, Coleman K, Starfield B, Anderson GF. Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses. Health Care Financ Rev. 1996;17:77-99.
16. Weiner JP, Starfield BH, Lieberman RN. Johns Hopkins Ambulatory Care Groups (ACGs). A case-mix system for UR, QA and capitation adjustment. HMO Pract. 1992;6:13-9.
17. Juncosa S, Bolíbar B, Roset M, Tomas R. Performance of an ambulatory case mix measurement system in primary care in Spain: Ambulatory Care Groups (ACGs). Eur J Public Health. 1999;9:26-35.
18. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. J Am Med Assoc. 1963;185:914-9.
19. Fries BE. Comparing case-mix systems for nursing home payment. Health Care Financ Rev. 1990;11:103-19.
20. Weissert WG, Musliner MC. Case mix adjusted nursing-home reimbursement: a critical review of the evidence. Milbank Q. 1992;70:455-90.
21. Lewis MA, Leake B, Clark V, Leal-Sotelo M. Case mix and outcomes of nursing home patients. The importance of prior nursing home care and admission from home versus hospital. Med Care. 1989;27:376-85.
22. Adams EK, Schlenker RE. Case-mix reimbursement for nursing home services: simulation approach. Health Care Financ Rev. 1986;8:35-45.
23. Arling G, Nordquist RH, Brant BA, Capitman JA. Nursing home case mix. Patient classification by nursing resource use. Med Care. 1987;25:9-19.
24. Fries BE, Cooney LM Jr. Resource utilization groups. A patient classification system for long-term care. Med Care. 1985;23:110-22.
25. Fries BE, Schneider DP, Foley WJ, Dowling M. Case-mix classification of Medicare residents in skilled nursing facilities: resource utilization groups (RUG-T18). Med Care. 1989;27:843-58.
26. Fries BE, Schneider DP, Foley WJ, Gavazzi M, Burke R, Cornelius E. Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG-III). Med Care. 1994;32:668-85.
27. Solano Jaurrieta JJ, Baztan Cortes JJ, Homillos CM, Carbonell CA, Tardon GA. Grupos de utilización de recursos en unidades de agudos y media estancia de servicios de geriatría. Rev Esp Salud Publica. 2001;75:249-61.
28. Stineman MG, Williams SV. Predicting inpatient rehabilitation length of stay. Arch Phys Med Rehabil. 1990;71:881-7.
29. Stineman MG, Escarce JJ, Goin JE, Hamilton BB, Granger CV, Williams SV. A case-mix classification system for medical rehabilitation. Med Care. 1994;32:366-79.
30. Dang DK, Pont JM, Portmoy MA. Episode treatment groups: an illness classification and episode building system - Part II. Med Interface. 1996; 9:122-8.
31. Dang DK, Pont JM, Portmoy MA. Episode treatment groups: an illness classification and episode building system - Part I. Med Interface. 1996; 9:118-22.
32. Ash AS, Ellis RP, Pope GC, Ayanian JZ, Bates DW, Burstin H. Using diagnoses to describe populations and predict costs. Health Care Financ Rev. 2000;21:7-28.
33. Kronick R, Dreyfus T, Lee L, Zhou Z. Diagnostic risk adjustment for Medicaid: the disability payment system. Health Care Financ Rev. 1996;17:7-33.
34. Kronick R, Zhou Z, Dreyfus T. Making risk adjustment work for everyone. Inquiry. 1995;32:41-55.
35. Hornbrook MC, Goodman MJ. Chronic disease, functional health status, and demographics: a multi-dimensional approach to risk adjustment. Health Serv Res. 1996;31:283-307.
36. Hughes JS, Averill RF, Eisenhandler J, Goldfield NI, Muldoon J, Neff JM. Clinical Risk Groups (CRGs): a classification system for risk-adjusted capitation-based payment and health care management. Med Care. 2004; 42:81-90.
37. Sloss EM, Solomon DH, Shekelle PG, Young RT, Saliba D, MacLean CH. Selecting target conditions for quality of care improvement in vulnerable older adults. J Am Geriatr Soc. 2000;48:363-9.
38. Rogers WH, Draper D, Kahn KL, Keeler EB, Rubenstein LV, Kosecoff J. Quality of care before and after implementation of the DRG-based prospective payment system. A summary of effects. J Am Med Assoc. 1990;264:1989-94.
39. Carpenter GI, Teare GF, Steel K, Berg K, Murphy K, Bjornson J. A new assessment for elders admitted to acute care: reliability of the MDS-AC. Aging (Milano). 2001;13:316-30.