Severity of illness, quality of care, and physician practice as determinants of hospital resource consumption.
Health care providers continue the debate over why it costs more to care for patients than the DRG reimbursement rate allows. This study examines severity of illness (measured by the AS-SCORE rating), quality of care (measured by the Adverse Patient Occurrences Inventory), and physician practice patterns as sources of variability in hospital resource use by patients in two DRGs. Both instruments independently account for some of the intra-DRG variability in length of stay and total charges. The study indicates that there is a positive relationship between severity of illness and decreased quality of care and that physician practice does not affect variation in resource use when cardiovascular complications, severity of illness, and quality of care are controlled.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D006745:Hospital Bed Capacity, 300 to 499; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000191:economics; D009518:New York; D010818:Practice Patterns, Physicians' / Q000191:economics*; D011787:Quality of Health Care; D012720:Severity of Illness Index