Kiesler C A, Simpkins C, Morton T
Vanderbilt University, Nashville, TN 37240.
Hosp Community Psychiatry. 1990 Feb;41(2):149-54. doi: 10.1176/ps.41.2.149.
Medicare's use of diagnosis-related groups and the frequent acceptance of length of stay as an indicator of resource utilization has caused a surge of interest in the predictability of length of hospital stay for psychiatric inpatients. By constructing a weighted least squares regression model using data from the 1980 Hospital Discharge Survey, the authors were able to account for an increased amount of variance in length of stay for the major diagnostic categories of mental disorder and substance abuse for Medicare and Blue Cross/Blue Shield patients. The enhanced ability to predict length of stay is attributed to a carefully constructed data base and an increased number of predictor variables, particularly comorbidity. Knowledge of the presence or absence of a chemical dependency unit in the hospitals from which patients were discharged substantially increased the proportion of variance accounted for in the analysis.
医疗保险对诊断相关组的使用以及经常将住院时间作为资源利用指标的做法，引发了人们对精神科住院患者住院时间可预测性的浓厚兴趣。通过使用1980年医院出院调查的数据构建加权最小二乘回归模型，作者能够解释医疗保险和蓝十字/蓝盾患者在精神障碍和药物滥用主要诊断类别中住院时间差异的增加量。预测住院时间能力的增强归因于精心构建的数据库和预测变量数量的增加，特别是合并症。了解患者出院的医院是否设有化学依赖单元，显著提高了分析中所解释的方差比例。
