Cross-validation of a patient classification procedure: an application of the U method

The objective of this article is to present the methods used for the validation of a patient classification system that was based on the concept of types of care (PCTC system). The PCTC system was developed to improve placement decisions for long-term care patients and also to provide information required for planning in the field of long-term care. A sample of long-term care patients was selected from various institutions/programs and the patients in the sample were assessed and classified by the program practitioners (users) as well as an independent panel (criterion team) composed of a physician, a nurse, and a social worker, using prototype forms specially designed for the project. An objective and empiric classification model was developed by applying discriminant analysis, Bayesian classification procedure, and cluster analysis techniques. The classification validity was evaluated by the use of the R, H, and U methods.