Severity-of-Illness Measurement: Applications in Quality Assurance and Utilization Review

American Medical Association. DRGs and the Prospective Payment System: A Guide for Physicians. Chicago, IL: American Medical Association, January 1986.

Aronow, D.B. "Severity of Illness Measurement: Applications for Health Care Providers." Master of Public Health Project Report, Division of Public Health, University of Massachusetts, Amherst, June 1987.

Backofen, J. , M.A. Ashworth , and S.D. Horn. "The Computerized Severity Index: A New Sophisticated Tool to Measure Hospital Quality of Care." Healthcare Forum 30, no. 2 (March/April 1987): 35-37.

Brewster, A.C. "Summary of MedisGroups." Lecture notes distributed and answers to questions at the seminar, "Severity and Complexity of Illness: An Examination of Five Leading Systems," sponsored by the American Hospital Association, 11-12 June 1987, Boston, MA.

Brewster, A.C. , R.C. Bradbury , and C.M. Jacobs. "Measuring the Effect of Illness Severity on Revenue under DRGs." Healthcare Financial Management 39, no. 7 (July 1985a): 52-60.

Brewster, A.C. , B.G. Karlin , L.A. Hyde , C.M. Jacobs , R.C. Bradbury , and Y.M. Chae. "MEDISGRPS: A Clinically Based Approach to Classifying Hospital Patients at Admission." Inquiry 22 (Winter 1985b): 377-87.

Burik, D. , and J.G. Nackel. "Diagnosis-Related Groups: Tool for Management" Hospital & Health Services Administration 26, no. 1 (Winter 1981): 25-40.

Chaiken, B.P. , and F.E. Steams. "A System for Quality Control under DRGs" DRG Monitor 4, no. 3 (November 1986): 1-8.

Clifford, L.A. , and M.P. Plomann. "Cost and Quality: Two Sides of the Coin in Cost Containment ." Healthcare Financial Management 39, no. 9 (September 1985): 30-32.

Coffey, R.M. , and M.G. Goldfarb. "DRGs and Disease Staging for Reimbursing Medicare Patients ." Medical Care 24, no. 9 (September 1986): 814-29.

Conklin, J.E. "Disease Staging: Background, Fact Sheet, Applications." Lecture notes distributed and answers to questions at the seminar, "Severity and Complexity of Illness: An Examination of Five Leading Systems ," sponsored by the American Hospital Association, 11-12 June 1987 , Boston, MA.

Conklin, J.E. , J.V. Lieberman , C.A. Bames , and D.Z. Louis. "Disease Staging: Implications for Hospital Reimbursement and Management." Health Care Financing Review 6, annual supplement (November 1984): 13-22.

Fetter, R.B. , Y.S. Shin , J.L. Freeman , R.F. Averill , and J.D. Thompson. "Case Mix Definition by Diagnosis-Related Group." Medical Care 18, no. 2, supplement (February 1980): 1-53.

Gertman, P.M. , and S. Lowenstein. "A Research Paradigm for Severity of Illness: Issues for the Diagnosis-Related Group System." Health Care Financing Review 6, annual supplement (November 1984): 79-90.

Gonnella, J. S. , ed. Disease Staging Clinical Criteria: Third Edition. Santa Barbara, CA: SysteMetrics/McGraw-Hill, November 1986.

Gonnella, J.S. , M.C. Hornbrook , and D.Z. Louis. "Staging of Disease: A Case-Mix Measurement." Journal of the American Medical Association 251, no. 5 (3 February 1984): 637-44.

Graves, F.W. , and S.H. Mendenhall . "Measuring Severity of Illness: Body Systems versus Disease Staging." Commission on Professional and Hospital Activities (CPHA), Ann Arbor, MI. No date.

Gustafson, D.H. , D.G. Fryback , J.H. Rose , V. Yick , C.T. Prokop , D.E. Detmer , and J. Moore. "A Decision Theoretic Methodology for Severity Index Development ." Medical Decision Making 6, no. 1 (January-March 1986): 27-35.

Health Systems International, Inc. CSI: Computerized Severity Index Software. New Haven, CT: Health Systems International, Inc. No date.

Horn, S.D. "Measuring Severity: How Sick is Sick? How Well is Well?" Health Care Financial Management 40, no. 10 (October 1986): 21,24,26,28,30-32.

. " The Computerized Severity Index (CSI)." Lecture notes distributed and answers to questions at the seminar, "Severity and Complexity of Illness: An Examination of Five Leading Systems," sponsored by the American Hospital Association, 11-12 June 1987 , Boston, MA.

Horn, S.D. , and R.A. Horn. "Reliability and Validity of the Severity of Illness Index ." Medical Care 24, no. 2 (February 1986): 159-78.

Horn, S.D. , P.D. Sharkey , A.F. Chambers , and R.A. Horn. "Severity of Illness within DRGs: Impact on Prospective Payment." American Journal of Public Health 75, no. 10 (October 1985): 1195-99.

Hombrook, M.C. "Hospital Case Mix: Its Definition, Measurement and Use: Part I. The Conceptual Framework." Medical Care Review 39, no. 1 (Spring 1982 a): 1-43.

. " Hospital Case Mix: Its Definition, Measurement and Use: Part II. Review of Alternative Measures." Medical Care Review 39, no. 2 (Summer 1982 b): 73-123.

Hospitals. "Johns Hopkins/HSI Severity System Introduced." Hospitals 60, no. 13 (5 July 1986): 106.

Iezzoni, L.I. , and M.A. Moskowitz. "Clinical Overlap among Medical Diagnosis-Related Groups." Journal of the American Medical Association 255, no. 7 (21 February 1986): 927-29.

Jencks, S.F. , A. Dobson , P. Willis , and P.H. Feinstein. "Evaluating and Improving the Measurement of Hospital Case Mix." Health Care Financing Review 6, annual supplement (November 1984): 1-11.

Knaus, W.A. , D.P. Wagner , and E.A. Draper. "The Value of Measuring Severity of Disease in Clinical Research on Acutely Ill Patients." Journal of Chronic Disease 37, no. 6 ( 1984): 455-63.

Knaus, W.A. , E.A. Draper , D.P. Wagner , and J.E. Zimmerman. "APACHE II: A Severity of Disease Classification System " Critical Care Medicine 13, no. 10 (October 1985): 818-29.

Kreitzer, S.L. , E.S. Loebner , and G.C. Roveti. "Severity of Illness: The DRGs Missing Link?" Quality Review Bulletin 8, no. 5. (May 1982): 21-34.

Louis, D.Z. , and J.S. Gonnella. "Disease Staging: Applications for Utilization Review and Quality Assurance." Quality Assurance and Utilization Review 1, no. 1 (February 1986): 13-18.

McIlrath, S. "Review System Based on Illness Severity." American Medical News 28, no. 1 (11 January 1985): 1,2, et passim.

McMahon, L.F. , and R. Newbold. "Variation in Resource Use within Diagnosis-Related Groups: The Effect of Severity of Illness and Physician Practice." Medical Care 24, no. 5 (May 1986): 388-97.

MediQual Systems, Inc. MedisGroups Software for Medical Care Quality Control. Westborough, MA: MediQual Systems, Inc., 1986.

Mendenhall, S. "DRGs Must Be Changed to Take Patient's Illness Severity into Account ." Modern Healthcare 14, no. 5 (15 November 1984): 86,88.

. " Measuring Severity of Illness: Alternative Approaches." Lecture notes distributed at presentation to the Healthcare Financial Management Association, 5 March 1987, Novi, MI.

Mullin, R.L. "Diagnosis-Related Groups and Severity: ICD-9-CM, The Real Problem." Journal of the American Medical Association 254, no. 9 (6 September 1985): 1208-10.

Pettengill, J. , and J. Vertrees. "Reliability and Validity in Hospital Case-Mix Measurement ." Health Care Financing Review 4, no. 2 (December 1982): 101-28.

Shachtman, R.H. , S.M. Snapinn , D. Quade , D.A. Freund , and A.K. Kronhaus. "A Method for Constructing Case-Mix Indexes, with Application to Hospital Length of Stay" Health Services Research 20, no. 6, Part I (February 1986): 737-62.

Simborg, D.W. "DRG Creep: A New Hospital-Acquired Disease." New England Journal of Medicine 204, no. 26 (25 June 1981): 1602-04.

Smits, H.L. , R.B. Fetter , and L.F. McMahon. "Variation in Resource Use within Diagnosis-Related Groups: The Severity Issue." Health Care Financing Review 6, annual supplement (November 1984): 71-78.

Thomas, J.W. , M.L.F. Ashcraft , and J. Zimmerman. "An Evaluation of Alternative Severity of Illness Measures for Use by University Hospitals (Volume 1—Management Summary)" Prepared for the University Hospital Consortium by the Department of Health Services Management and Policy, School of Public Health, The University of Michigan, 29 December 1986, Ann Arbor, MI.

Vladeck, B.C. "Medicare Hospital Payment by Diagnosis-Related Groups." Annals of Internal Medicine 100 (April 1984): 576-91.

Wagner, D.P. , and E.A. Draper. "Acute Physiology and Chronic Health Evaluation (APACHE II) and Medicare Reimbursement." Health Care Financing Review 6, annual supplement (November 1984): 91-105.

Wagner, D.P. , W.A. Knaus , and E.A. Draper. "Statistical Validation of a Severity of Illness Measure ." American Journal of Public Health 73, no. 8 (August 1983): 878-84.

Wagner, D.P. , E.A. Draper , R.A. Campos , P. Nikki , J.R. LeGall , P. Loirat , and W.A. Knaus. "Initial International Use of APACHE: An Acute Severity of Disease Measure." Medical Decision Making 4, no. 3 (1984): 297-313.

Wood, T.J. , and S.E. Thomas. "Severity of Illness and Diagnosis Related Groups." The Medical Journal of Australia 145 (21 July 1986): 79-81.

Young, W.W. "Incorporating Severity of Illness and Comorbidity in Case-Mix Measurement ." Health Care Financing Review 6, annual supplement (November 1984): 23-31.

. " ICD-9-CM Code and Coding Practice Changes for Case Mix Measurement" Journal o f the American Medical Records Association 57, no. 3 (March 1986a): 29-33.

. Principal Investigator. "Measuring the Cost of Care Using Patient Management Categories" Health Care Financing Administration Project Summary, Grant No. 18-P-97063/3, 1986b.

. " Patient Management Categories." Lecture notes distributed and answers to questions at the seminar, "Severity and Complexity of Illness: An Examination of Five Leading Systems," sponsored by the American Hospital Association, 11-12 June 1987, Boston, MA.