Wingert T D, Kralewski J E, Lindquist T J, Knutson D J
Institute for Health Services Research, University of Minnesota, Minneapolis 55455, USA.
Inquiry. 1995;32(4):430-43.
There is growing agreement that episodes of care methodology provides the most effective means of analyzing health care delivery because it organizes health care services around the condition or illness for which they were prescribed. This paper presents a computerized approach for developing episodes of care from encounter and claims data and discusses some methodological issues. We found that we could group into five generic types of episodes of care the 31 illnesses that incur the majority of expenses for a health maintenance organization. This article describes the process for developing these types and summarizes the specific criteria defining the episodes of care for the 31 illnesses.
越来越多的人达成共识，即护理事件方法提供了分析医疗服务提供的最有效手段，因为它围绕所开处方的疾病或病症来组织医疗服务。本文提出了一种从就诊和理赔数据中开发护理事件的计算机化方法，并讨论了一些方法学问题。我们发现，我们可以将健康维护组织中产生大部分费用的31种疾病归为五种通用类型的护理事件。本文描述了开发这些类型的过程，并总结了定义这31种疾病护理事件的具体标准。
