An Application of Case-Mix Adjusted Lengths of Stay in Naval Medical Treatment Facility's Output Measurement

摘要

The absence of a meaningful measure of hospital output is widely recognized. Common measures such as inpatient length of stay, discharges, or Composite Work Units do not fully consider the mix of patients hospitalized and are at best rough partial indicators of output. The intent of this study is to determine whether length of stay, a common output measure, which is adjusted for case-mix, is a better partial indicator than non-adjusted length of stay. This hypothesis was tested with three analyses, using the inpatient admission/disposition records for 24 selected naval medical treatment facilities for calendar year 1978, and found to be correct. For each analysis two indices are developed to evaluate the overall change in length of stay: the first index evaluating changes due to differences in case-mix; the second index evaluating changes due to differences in length of stay for each case-mix type. (Author)