Panniers T L, Tomkiewicz Z M
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AS-SCORE, applied to DRGs, has the potential for providing a system of case-mix measurement that will be more meaningful to physicians, nurses, and hospital administrators as they attempt to predict their patients' use of hospital resources. Urban hospitals and teaching hospitals may find such a system crucial to adequate reimbursement for the more severely ill patients they treat. The system is easily taught and gives reliable scores. The system is clinically coherent because it takes into account all of a patient's conditions and complications. When combined with a cost accounting system for nursing services, the system is sensitive to patients' nursing care requirements. Further studies should be conducted to determine the applicability of AS-SCORE to other nonhomogeneous medical and surgical groupings of the I-9 DRG system. Not all DRGs may need to be subcategorized by a severity-of-illness measure; some DRGs, for example, contain patients who are very similar, such as those who undergo tonsillectomy or normal vaginal delivery. Thus, if subcategorization by severity is not needed for all DRGs, it may be possible to use the AS-SCORE measure and, at the same time, to keep the number of groups small enough to be manageable. These studies should also be conducted in hospitals in other parts of the country to determine the replicability of the findings despite regional variations in facilities and practice methods.
应用于诊断相关分组（DRGs）的AS - SCORE有潜力提供一种病例组合测量系统，对于医生、护士和医院管理人员在试图预测患者对医院资源的使用情况时更有意义。城市医院和教学医院可能会发现这样一个系统对于为他们所治疗的病情较重的患者获得足够的补偿至关重要。该系统易于传授且评分可靠。该系统在临床上具有连贯性，因为它考虑了患者的所有病情和并发症。当与护理服务成本核算系统相结合时，该系统对患者的护理需求很敏感。应进行进一步研究以确定AS - SCORE在I - 9 DRG系统的其他非同类医疗和外科分组中的适用性。并非所有DRGs都需要按疾病严重程度进行细分；例如，一些DRGs包含非常相似的患者，如那些接受扁桃体切除术或正常阴道分娩的患者。因此，如果并非所有DRGs都需要按严重程度进行细分，那么有可能使用AS - SCORE测量方法，同时保持分组数量足够少以便于管理。这些研究还应在该国其他地区的医院进行，以确定尽管设施和实践方法存在地区差异，研究结果的可重复性。
