Gonnella J S, Hornbrook M C, Louis D Z
JAMA. 1984 Feb 3;251(5):637-44.
Measurement of illness severity is required to evaluate diagnostic efficiency of physicians, assess quality of care, understand utilization of health services, design clinical trials, and reimburse hospitals on the basis of output. "Staging" is a method for measuring severity of specific, well-defined diseases. Staging defines discrete points in the course of individual diseases that are clinically detectable, reflect severity in terms of risk of death or residual impairment, and possess clinical significance for prognosis and choice of therapeutic modality. Medical staging criteria have been developed for 420 diagnoses and converted into "coded" criteria for the major diagnostic coding systems. Coded criteria can be efficiently applied to computerized hospital discharge abstracts to derive a comprehensive case-mix classification system. Uses of staging in epidemiologic, case-mix, and utilization analyses are illustrated for diabetes mellitus.
为了评估医生的诊断效率、评估医疗质量、了解卫生服务的利用情况、设计临床试验以及根据产出对医院进行报销，需要对疾病严重程度进行测量。“分期”是一种测量特定的、明确界定的疾病严重程度的方法。分期定义了个体疾病过程中临床上可检测到的离散点，这些点反映了死亡风险或残留损伤方面的严重程度，并且对预后和治疗方式的选择具有临床意义。已经为420种诊断制定了医学分期标准，并将其转换为主要诊断编码系统的“编码”标准。编码标准可以有效地应用于计算机化的医院出院摘要，以得出一个全面的病例组合分类系统。文中以糖尿病为例说明了分期在流行病学、病例组合和利用分析中的应用。
