This study examined the validity of four psychiatric utilization management criteria sets : the 1992 and 1993 InterQual Intensity, Severity, and Discharge (ISD) criteria, the Managed Care Appropriateness Protocol, and an instrument developed by the Department of Veterans Affairs (VA).
The appropriateness of acute care admission and continued stay for 70 randomly selected VA psychiatric inpatients was retrospectively assessed with each criteria set.
The sensitivity and specificity of each instrument were evaluated by comparing its assessments to the consensus of judgments ofa panel ofexpert psychiatrists who reviewed the same cases.
Sensitivity was defined as the proportion ofadmissions or continued-stay days the panel found appropriate for acute care that the criteria judged to be appropriate for acute care ; specificity was the proportion the panel found inappropriate for acute care that the criteria judged to be inappropriate for acute care.
For admissions, there were only minor differences in the validity of the four criteria sets as assessed by agreement with the panel's judgments.
For each of 4 continued-stay days studied, either the sensitivity or specificity of the 1993 InterQual ISD criteria was below 0.30.
The specificity ofthe 1992 InterQual ISD criteria was below 0.60 for 2 days.
In contrast, for the Managed Care Appropriateness Protocol, sensitivity was 0.73-0.93 and specificity was 0.78-0.88 over the 4 days. (...)
Mots-clés Pascal : Psychiatrie, Critère, Gestion hospitalière, Qualité, Soin, Analyse coût, Economie santé, Système santé, Etats Unis, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Psychiatry, Criterion, Hospital management, Quality, Care, Cost analysis, Health economy, Health system, United States, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0219550
Code Inist : 002B18H05B. Création : 21/05/1997.