Iezzoni L I
Boston University School of Medicine, Massachusetts.
QRB Qual Rev Bull. 1989 Dec;15(12):376-82. doi: 10.1016/s0097-5990(16)30320-7.
Five severity measurement systems--APACHE II, Computerized Severity Index, Disease Staging (both Q-Scale and clinical criteria version), MedisGroups, and Patient Management Categories--were applied to three clinical cases. Severity results and recommendations for quality review were then compared and contrasted. Systems that define severity based on resource need produce different impressions than those that define severity in more clinical terms. In-depth quality review is generally suggested when severity scores later in the hospital stay are higher than at admission. Recommendations for review may be automatic or tied to other factors. Some systems use normative data, based on observed severity patterns and patient outcomes, to guide decisions about quality reviews.
将五个严重程度测量系统——急性生理与慢性健康状况评分系统II（APACHE II）、计算机化严重程度指数、疾病分期（Q量表和临床标准版本）、医疗分组系统（MedisGroups）以及患者管理分类——应用于三个临床病例。然后对严重程度结果和质量审查建议进行了比较和对比。基于资源需求定义严重程度的系统与那些用更多临床术语定义严重程度的系统会产生不同的印象。当住院后期的严重程度评分高于入院时，通常建议进行深入的质量审查。审查建议可能是自动生成的，也可能与其他因素相关。一些系统使用基于观察到的严重程度模式和患者预后的规范数据来指导质量审查决策。
