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C- ' MIX DEFINITION BY DRG TABLE 11. - 56 - No. of Per Cent Variable Groups Reductiba age 3 1 ..05 oper2 1 0.0 dxl 1 0.0 %ex I 0.0 down ofthe surgical groups on the basis of secondary diagnosis. Moreover, in light of one of the major objectives of' keeping the total number of classes low, additional groups formed at this stage of the partitioning of Urinary Calcultus patients would be of questionable value. Therefore, the 2 surgical grotups were not divided further but were considered terminal groups. Step 5 The 2 subgroups formed from the nonsurgical cases on the basis of presence or absence ofother díagnoses were evaluated to determine if they should be partitioned further or left intact as terminal groups. The algorithm was applied and produced the results shown for the nonsurgical cases without multiple diagnoses. The algorithm produced the results listed in Table 11 for the nonsurgical cases with multiple diagnoses. With respect to the nonsurgical cases without multiple diagnoses, both sets of groups font - - ,n the basis of age and secondary sa ,ncal procedure, respectively, MEDICAL CARE were determined unacceptable. In each instance, more than 95 per cent of the ob. pervations fell into the first group, leaving the second group with fewer than 25 cases. For the nonsurgical cases with multiple diagnoses, the 3 groups formed using age levels were considered as potential sub.. groups. The age levels detining the bound. aries of the groups were 66 and 70. This partition was rejected for reasons similar to those above, namely, the lopsided distribution ofl cases in thle groups. Almost 90 per cent of the observations had an age under 66. Thus, the nonsurgical groulps with aind without multiple diagnoses were consíidered terminal groups. We conclude, then, that specific surgical procedures and the presence of multiple diagnoses were ímportant variables in predictir.g length of stay for urinary calculus patients. The 4 DRGs formed were significantly different (a = 0.01) with respect to their average lengths of stay and are clinically interpretable. To be sure, by overruling some ofthe partitions suggested by the algorithin, a certain anmoulnt of explanatory power was sacrificed. But, the trade-off was generating a reasonable number of subgroups or DRGs which could be interpreted from a medical perspective. Figure 2 presents a descriptive summary ofthe length-of-stay distributions for the groups formed as part of the partitioning process in this example.
- 57 - MEDICAL CARE Febiuary 1980, Vol. XVIII, No. 2. Supplemteilnt 3. Interpretation of the DRGs in Health-Care Studies THE DRGs AS CONSTRUCTED met the original rese:trch objectives; that is, they provide a detinition of case types by relative output ::tilization, where the definition of case type ¿has the fillowing properties: 1. The varialbles iste in ti the deinition ol a case are li¡¡¡ited( t tthose reflirring to the patient's ;at ilre 'tiillilllll
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L 00111111 MASTER COPY - NO TOCAR B
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- ii - liancock, W., D. Magerlein y
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FOREWORD These last years, PAHO wit
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Workshop .- Education in Operationa
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-3. The format of the workshop was
Page 11 and 12: -5- 2. Programs for bringing togeth
Page 13 and 14: II. R.commendations -7- A series of
Page 15 and 16: -9- there are technically trained i
Page 17 and 18: -11- and selected individuals who h
Page 19 and 20: -13- 6. In order to improve the qua
Page 21 and 22: -15- cnve!opment will typically be
Page 23 and 24: -17- 16. All participants sbould pr
Page 25 and 26: A. Short Courses -19- Short courses
Page 27 and 28: -21- 4. Presentation of a case to b
Page 29 and 30: Topic Introduction to Systems Analy
Page 31 and 32: -25- 12. Elementary Statistics ior
Page 33 and 34: -27- 8. Applications of data proces
Page 35 and 36: -29- problems. The graduate should
Page 37 and 38: -31- Lblo-w. Also given is that typ
Page 39 and 40: - 33 -' -Case Mix Definition by Dia
Page 41 and 42: - 35 - Acknowledgment The authors w
Page 43 and 44: ML ICAL CAE1 Februurl 1980, Vol. XV
Page 45 and 46: X;' VIII, No. 2. Suippllce,t - 39 -
Page 47 and 48: - 41 - dMLDICAL C.ARE '.Fcbrtanj 19
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Page 89 and 90: T XVIII. No. 2. S.pphlts"t .i¿jor
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Page 107 and 108: V - 101 - McUCi. (:Au AWuu IMI. VoL
Page 109 and 110: GREENLAND ET AL - 103 - the case (p
Page 111 and 112: CREENLAND iT AL - 105 - TABLE 2. Fi
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GREENLAND ET AL. 3. Cornfleld J, Ha
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160 I indicates the flow of patient
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162 CONGESTION POINTS ANU CONTROL.A
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164 c 8o Table 4. The cffect of cha
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166 B. LEV etal. significant differ
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MEREDITH - 117 - ciety. However. ch
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I MEREDITH - 119 - varying oulcome
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MEDICAL CARE ,arch 1981, Vol. XIX,
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%,I. XIX, No. 3 iclnts. It should d
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n'ol. XIX, No. 3 - 125 - tailed exa
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1 Vol. XIX. No. 3 - 127 - tant for
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Vi. .XIX, No. 3 - 129 - tom' s reco
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- 131 - A \ ,,1. XIX, No. 3 PEHFOHR
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V Xl. IX, No. 3 - 133 - PERFORMANCE
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- 135 - The fourth requirement is l
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- 137 - Systems and Procedures of P
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- 139 - 2. ldentify problemn areas
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c 1 '-a
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u. o a.- 1 W. LZi - 143 - c c S C.
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- 145 - Thc cu rrent appointmren t-
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- 147 - A pure block appointment sy
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- 149 - ihe future. It was discover
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- 151 -
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- 153 - Figui.'¢ VII. Patient Arri
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- 155 - sonnel working in positions
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- 157 - 17. Keep the time span of t
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- 159 - TABLE I: Pnmary DesklConsul
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.Recomme;tded systenz - 161 - .;any
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- 163 - system, there is nr'. :vste
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- 165 - - A major problem with such
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- 167 - T1c Iteole of Olieraionls R
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- 169 - Larry J. Shumc- Harvey Wolf
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- 171 - '- ionoal Heolth Ploanning
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- 173 - Regional Health Planning ar
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- 175 - Regio.,oi Health Planning w
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- 177 - Regionao rfeclth Planning l
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A^CJonoal neonah ronning 21. 1'. F.
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- .,1 - Programming, Budgeting, and
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- 183 - the health care industí ,
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- 185 - was apparently no scarcity.
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ut, u a. íL ._c E 0 t42 a .. 0m u
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plex stochastic distribution of arr
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- 191 cumulated according to any or
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- 193 - Step 2 represents the heart
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ÍA en .aa
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- 197 - analysis, forecasting, and
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Budgeting Attitudes - 199 - The pla
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- 201 Health Services Research most
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a. - 203 - Health Services Research
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- 205 - DESIGN OF ALTERNATIVE PROVI
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- 207 - 1. A change in the immigrat
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- 209 - accessibility of health car
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- 211 - dimensional graph to illust
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- 213 - Primary Care Health Service
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- 215 - different health and educat
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- 217 - The tasks that were rated "
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IC1 o -a - i - w im W..i C -J M. -
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0 z 0 u _ I- 0 Ut. I,, uj CD Q U- ,
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TABLE 3 TASK ANALYSIS OF MALNUTRITI
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11 - 225 - TASK ANALYSIS OF MALNUTR
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- 227 - 12. Reisman, A., F.Staub, B
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- 229 - METHODS Parameters Affectin
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- 231 - ~HNCOCK Fig. 1. Daily censu
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- 233 - HANCOCK Table 1. Parameters
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- 235 - Fig. 3. Maximum average occ
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- 237 - HANCOCK ET AL Fig. 4. Maxim
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- 239 - AECOCL. Table 2. Eflect of
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- 241 - HANCOCK Discussion ET AL Th
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#12 Estinating the Need for Additio
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Pri c= arvicc a ia Indina. - 245 -
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. 1' - - IIINDLE Algorithmn for Det
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- 249 - HINDLE that all tlie primar
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- 251 - HINDLE 6. Computc Mhe Avail
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- 253 - HINDLA Tablek Meamm of Zfic
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HINDLE Tr AL HIALTH falvCU - 255 -
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- 257 - HIiDLZ 26. Ado, An . ad L.
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- 259 - REISMIAN, DEAN, ESOOBUE, AG
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- 261 - REISMAN, DEAN, ESOGBUE, AGG
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- 263 - 1350 REISMiAN, DEAN, ESOOBU
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- 265 - REISMAN, DEAN, ESOOBUE, AGO
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- 267 - 1354 REISMAN, IEAN, ESOGCUE
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- 269 - William J. Abernothy and Jo
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- 271 - William J. Abernathy and Jo
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- 273 - William 1. Abernothy ond Jo
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- 275 - William J. Abrnarthy and Jo
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- 277 - William J. Abernathy and Jo
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- 279 - William J. Aberncthy and Jo
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- 281 - 642 William J. Abernathy an
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Decmand in Mintu és/Day Numnlber o
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Disposal System 326 IIstlic I,',i,
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i Trays 334 Colorful pattenis anid
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tiie, gency L:ghting 347 ,i',., .:.
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- 296 - REVEI.LE we believe to be t
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- 293 R£VELLE is apparent in light
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- 295 - REVEt.EI. ET AL. poSJcd pro
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- 297 - RM.VELLE EL AL. of faciliti
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REVELLE ET AL. HALTOI SERVICUS RESE
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REVELLE ET Al.. - 301 - Fig. 4. Ano
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- 303 - REVet. ¡T AL Act of 1973.
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- 305 - REVELLE possible within ilh
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- 307 - RLVELI.E 29- Khumawala. a.
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- 309 - assuring thal the maxinmum
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-311 - the implemented strategy he
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- 313 - analytical approximalions w
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- 315 - rcquired Ior shipping and o
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- 317 - Controlling ¡he system The
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- 319 - The light pen techniques ar
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- 321 - shipnients have to be on ro
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- 323 THE CREATER NEIW' YORK BLOOD
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_,~ .- - 3. 2- - TABLE 1. PATIENT C
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TABLE 3. MEDICAL INTENSIVE CARE UNI
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Nursing Stalf Level (i of nurss/day
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Table 1. Factors ¡i denad for medi
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e forecast. This section descijbcs
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ei, paid to these standards in cond
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O Emphasis u.on the explicit enumer
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*1 1 21 1 «i 1 1 1 1 - 331, -- For
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Therc are ihreec basic prcessecs fi
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- 343 - Forecasting Hcalth Care Ser
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#20 Jaime 1B. Henrs Rtxlnc. I.. Ro:
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- 347 - I v,'N ti.K 1tHm.pi.l !, t1
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Ra.fo.renem.. aid %.hs '. - 31!9 -
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; / larman u empirical research has
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I Klarman - >3 - benefits that for
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I Klaman Ctitena for Inchmion - 355
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IClarman - 37 - The prevailing tend
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1 Klarman Intargibl Benefits - .5 -
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Kllarman - 361 - thi prospects of r
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- 363 - Thua, it did not consider w
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I Klannan - 365 - again if the new
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Klarman - 367 - At the other pole,
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- 369 - seem worth exploring. Howev
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iKlarman - 371 - in the use of serv
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Kmnnan - 373 - REFERENCES 1. Havema
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- 375 - 59. Valr y, W. S. One eonoi
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- 377 - i aSll a _ . b, CuaMu L. L,
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WAHRNER ANI) I|UTTr)N The puroses I
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WARNER AND HUTfON - 381 - observers
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.AHNF:R AND IIl'TIoN - 383 - rare I
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WARNER AND HUTTrU., TABLE 1. Trenda
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W'AHNER AND IHUTTON - 387 - treatme
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AAHNER AND HU'TON - 389 - Several d
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WARNER AND HUTTON pal orientations
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w'ARNER AND UL'TTOit'u ' . N Engl I
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I,,qr *ir 'ilu.,i XV. Seplteri¡br
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In.lumin- i',)i.eIu XV. Seph.irhb'r
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In#unrvlVolutn XV. September 1978 h
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Problemas identificados - 401 - Dur
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Programas educativos 3 - 403 - 1. S
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- 405 - maestrfa, donde se supone q
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- 407 - presentación formal de inf
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- 409 - * Curso para ingenieros ind
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- 411 - ¢ 16. Hancock, W., D. Mage
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- 413 - 2. Barrenechea, J. J. La se
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- 415 - Curwso (8 a 16 horas) para
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- 417 - 4. Necesidades de los admin
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MOISES ARTEAGA DR. DAVID GOMEZ COVA
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