BOOKS OF RtfiDIfGS - PAHO/WHO

CASF MIX DEFINITION BY DRG
- 38 -
ulatory agencies for inter-institutional
comparisons. In particular, the ovutcome
ancd cost of the individual patient care
processes that give rise to the hospital
products cannot be adequately determined.
As a cose(ltence, admiiiiiistrators and
clinicians caninot ascertain the quality aud
cost iimplications of the treatment plans
practiced withi.. the insitution nor can regulators
assess the impact of alternative
mietlhods aross institutions.
In order to evaluate, conmpare, and provide
relevant feedback regarding hospital
perl>onnaiice, it is necessary to idcntity the
specific products that institutions -,rovide.
As defiled above, a hospital product is a set
of services provided to a patient as part of
the treatment process coiltrolled by his
clinician. While each individual patient
adlmitted to an institultion is unique, he has
certain demographic, diagnostic and
therapeutic attributes in common with
other patients that determine the type and
level of services he receives. If these classes
of patients with the same clinical attributes
and similar processes of care can be
identified, then the framework within
which to aggregate patients into case types
is established. Moreover, if these classes
cover the entire range of inpatients in the
acutte-care setting, then collectively they
constitute a classification scheme that provides
a means for examining the products
of the hospital, since patients within each.
class are exr-cted to receive a similar
product.
The means of defining hospital case mix
for this purpose is the construction and ap-
Flication of a classification scheme comprised
of subgroups of patients possessing
similar clinical attributes and output utilization
patternls. This itnvolves relating the
demographic, diagnostic and therapeutic
characteristics of patients to the output
they are provided so that cases are c"rerentiated
by only those variables related to
lihe c