BOOKS OF RtfiDIfGS - PAHO/WHO

CASE ' : DEFINITION BY DRG
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MIEDICAL CARe
number of bed days consumed per dis.
charge. A case mix-adjusted length of stay
(CASE MIX ADJUSTED LOS) appears íu
.colunin 4 and is the mean length of stay the
hospital would have experienced with the
region's case mix. For the ith hospital, it is
computed as
j
J PJ j= 1,.... -383 (DRG) (4.1)
where au is the average stay in thejth DRC
in hospital i, and Pj is the proportion of the
region's cases i¡i )RG j. As such, it stamil.
ardizes or holds constantcase mix across all
institutions and results in a measure that
one can use to compare hospital utilization
based oa length of stay.
As a complement to the case mixadjusted
length of stay, column 5 contains
the average length of stay the hospital
would have experiencgld with its owtn catse
mix, but the region's average length of
stay within each of the DRGs (LOS
WEIGHTED CASE MIX). That is, for the
ith hospital it is computed as
A p, j = ....,383 (DRG) (4.2)
where AN is the region's average stay in the
jth DRG, and pu is the proportion of the íth
hospita's cases in thejth DRG. Since it uses
a standard set of relative weights (Aj) ftr the
DRGs, it can be interpreted as a relative
measure of case mix complexity, with
higher values indicating a more complex
case mix, that is, a greater proportion of
cases receiving a high amount ofthe hospital
outputs. In interpreting this measure, it
should be noted that complexity is a function
of both the condition of patients as
well as the treatment process selected by
physicians. Columns 6 through 8 are indices
computed by dividing the measures in
columns 3 through 5, respectively, by tlhe
region's average length of stay.
Columns 9 through 12 present the observed
difference between the institution's