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Related Experiment Videos

Disease staging--a case-mix system for purchasers?

M McKee1, M Petticrew

  • 1Health Services Research Unit, London School of Hygiene and Tropical Medicine.

Journal of Public Health Medicine
|March 1, 1993
PubMed
Summary
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The Disease Staging case-mix system effectively groups UK hospital patients by similar outcomes and resource use. This validated system is acceptable to clinicians and useful for purchasers in the National Health Service internal market.

Area of Science:

  • Health Services Research
  • Health Economics
  • Clinical Informatics

Background:

  • The National Health Service (NHS) internal market necessitates detailed hospital activity data for purchasers.
  • Existing case-mix systems developed in the United States may lack validity and acceptability in other countries.
  • A need exists for condensing diagnostic codes into clinically meaningful patient groups for resource allocation and quality assessment.

Purpose of the Study:

  • To evaluate the validity and acceptability of the Disease Staging case-mix system using United Kingdom (UK) hospital data.
  • To determine if Disease Staging can create homogeneous patient groups based on length of stay and mortality.
  • To assess the suitability of Disease Staging for use by purchasers within the UK internal market.

Main Methods:

Related Experiment Videos

  • Evaluation of the Disease Staging case-mix system using routine hospital activity data from the UK.
  • Analysis of patient groups for homogeneity in terms of length of stay and mortality.
  • Assessment of the clinical acceptability of the Disease Staging system's logic among UK clinicians.

Main Results:

  • The Disease Staging system, when applied to UK data, successfully produces patient groups that are homogeneous in length of stay.
  • Mortality rates within the Disease Staging groups were also found to be homogeneous.
  • The underlying logic of the Disease Staging system was deemed acceptable by UK clinicians.

Conclusions:

  • Disease Staging is a valid and acceptable case-mix system for use with UK hospital data.
  • The system can aid purchasers in the NHS internal market by providing meaningful patient groupings for cost and quality assessment.
  • Further discussion is warranted on the practical implementation of Disease Staging using routine hospital data for healthcare purchasers.