Hirsch E O, Rimm A A, Welsch R G
Med Care. 1977 Nov;15(11):906-14. doi: 10.1097/00005650-197711000-00004.
A classification of in-patients by "reason for admission" (RFA) is described and compared with the classification by diagnosis. The RFA classification assigns length of stay on the basis of twenty-five reasons for admission for adult medical-surgical cases. Length of stay norms for the RFA method were developed and compared to diagnosis specific norms (dx norms). A group of 500 charts was subjected to simulated continued stay review using both RFA and dx norms as screening methods. Although the dx norms screened out for individual review 76% more cases than the RFA norms, the number of screened out cases in which length of stay could have been reduced without affecting the quality of care was the same. The RFA strategy may provide a more efficient method of continued stay review that is also more relevant to hospital medical care than the standard method based on diagnosis.
本文描述了一种按“入院原因”（RFA）对住院患者进行分类的方法，并将其与按诊断分类进行比较。RFA分类法根据成人内科 - 外科病例的25种入院原因来确定住院时间。制定了RFA方法的住院时间标准，并与特定诊断标准（dx标准）进行比较。使用RFA和dx标准作为筛查方法，对一组500份病历进行了模拟持续住院审查。尽管dx标准比RFA标准筛选出进行个体审查的病例多76%，但在不影响护理质量的情况下可以缩短住院时间的筛选出病例数量是相同的。与基于诊断的标准方法相比，RFA策略可能提供一种更有效的持续住院审查方法，且与医院医疗护理更相关。
