Use of severity to evaluate appropriateness of admissions and length of stay

We undertook a case study for a Canadian teaching hospital to see if use of a severity of illness system could facilitate management of utilization practice in the hospital. The two issues selected were low severity emergency room admissions and length of stay on medical services. Use of a severity system allows for comparisons within case mix groups and also should control for large differences in severity within CMGs. The results of the study were consistent with the prior expectation of the hospital with respect to the relative efficiency of the physicians under study.