Episode treatment groups: an illness classification and episode building system--Part II.
The episode treatment group (ETG) methodology is a case-mix adjustment and episode-building system that uses routinely collected claims data. The resulting 558 clinically homogeneous groups adjust for severity by the presence of complicating conditions, comorbidities, and other characteristics of a patient's condition that affect resource utilization. The groups identify both complete and incomplete episodes in addition to those episodes which, from a cost perspective, are either low or high outliers. As a grouping ¿engine,¿ the user controls the amount and format of the claims data as input, providing essentially unlimited provider profiling, demand analysis, disease management, and capitation and predictive modeling possibilities.
Dang
D K
DK
Symmetry Health Data Systems, Inc., Phoenix, AZ, USA.
Pont
J M
JM
Portmoy
M A
MA
D001991:Bronchitis / Q000145:classification / Q000191:economics / Q000453:epidemiology; D002908:Chronic Disease / Q000145:classification / Q000191:economics*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000145:classification / Q000191:economics / Q000453:epidemiology; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics; D017050:Episode of Care; D006801:Humans; D007344:Insurance Claim Reporting; D008297:Male; D008722:Methods; D010347:Patient Care Planning; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology