McKee M, Petticrew M
Health Services Research Unit, London School of Hygiene and Tropical Medicine.
J Public Health Med. 1993 Mar;15(1):25-36. doi: 10.1093/oxfordjournals.pubmed.a042816.
The National Health Service (NHS) internal market has directed renewed attention at hospital activity data. Purchasers require information on the cost of care provided for them, the quality of service and the extent to which their population's needs are being met. There is a need for a means of condensing the large number of diagnostic codes into groups containing patients with similar outcome or resource use, i.e. case-mix systems. These systems have been developed in the United States to overcome this problem. Unfortunately, they may not be valid or acceptable in other countries. We describe the evaluation of one such system, Disease Staging, in the United Kingdom. We conclude that it can be used with UK data to produce groups that are homogeneous both in terms of length of stay and mortality. Its logic is acceptable to UK clinicians. We discuss the major issues involved in using routine hospital data and suggest ways in which Disease Staging might be used by purchasers in the UK internal market.
国民医疗服务体系（NHS）内部市场已将人们的注意力重新引向医院活动数据。购买方需要有关为其提供的护理成本、服务质量以及其人群需求得到满足程度的信息。需要一种方法将大量诊断代码浓缩成包含具有相似结果或资源使用情况患者的组，即病例组合系统。这些系统已在美国开发出来以解决这一问题。不幸的是，它们在其他国家可能无效或不被接受。我们描述了对英国的一种此类系统——疾病分期系统的评估。我们得出结论，它可用于英国数据，以生成在住院时间和死亡率方面均具有同质性的组。其逻辑为英国临床医生所接受。我们讨论了使用常规医院数据所涉及的主要问题，并提出了英国内部市场购买方可能使用疾病分期系统的方式。
