Horn S D, Schumacher D N
Med Care. 1979 Apr;17(4):382-9. doi: 10.1097/00005650-197904000-00006.
Case mix complexity measurements are essential to determine health care efficiency and effectiveness. Measures of patient care processes and outcomes must be adjusted for case mix before valid comparisons can be made. Hospital reimbursement, particularly prospective reimbursement, must take into account differences in case mix. In addition, a key variable for hospital classification is case mix. There are, however, no widely accepted easily computed case mix measures. Information theory measures of case mix have been developed but their acceptance has been limited by a lack of verification of their basic assumption that concentration of disease is related to clinical complexity. We discuss the rationale underlying the mathematical computaton of information theory measures and demonstrate a statistically significant relationship between clinical measures of case mix complexity and information theory measures of case mix complexity.
病例组合复杂性测量对于确定医疗保健的效率和效果至关重要。在进行有效比较之前,必须针对病例组合对患者护理过程和结果的测量进行调整。医院报销,尤其是前瞻性报销,必须考虑病例组合的差异。此外,病例组合是医院分类的一个关键变量。然而,目前尚无被广泛接受且易于计算的病例组合测量方法。虽然已经开发了病例组合的信息论测量方法,但由于缺乏对其基本假设(即疾病集中与临床复杂性相关)的验证,其接受程度有限。我们讨论了信息论测量方法数学计算背后的基本原理,并证明了病例组合复杂性的临床测量与病例组合复杂性的信息论测量之间存在统计学上的显著关系。