The Duke Case-Mix System (DUMIX), which combines age, gender, patient-reported perceived and physical health status, and provider-reported or auditor-reported severity of illness to classify patients by their risk of high future utilization, explained 17.1% of the variance in future clinic charges and 16.6% of the variance in return visits.
When a random half of 413 ambulatory adults were classified into four risk classes by predictive regression coefficients from the other half, there was a stepwise increase in actual future utilization by risk class.
The most accurate classification was for Class 4 (highest risk) patients, with a sensitivity of 40.8%, specificity of 82.1%, and likelihood ratio of 2.3. These 23.7% of patients accounted for 44.2% of charges for all patients.
When predictive coefficients from this population were used to classify a different group of 206 ambulatory adults, past utilization also increased in stepwise order by case-mix class.
Mots-clés Pascal : Soin intégré, Ambulatoire, Classification, Malade, Homme, Autoévaluation, Evaluation, Indice gravité, Capacité fonctionnelle, Prédiction, Utilisation, Service santé, Etats Unis, Amérique du Nord, Amérique, Psychométrie, Age, Sexe
Mots-clés Pascal anglais : Managed care, Ambulatory, Classification, Patient, Human, Self evaluation, Evaluation, Severity score, Functional capacity, Prediction, Use, Health service, United States, North America, America, Psychometrics, Age, Sex
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0404517
Code Inist : 002B30A01C. Création : 25/01/1999.