Impact of Hospital Variables on Case Mix Index as a Marker of Disease Severity

Mendez, Carmen M.; Harrington, Darrell W.; Christenson, Peter D.; Spellberg, Brad

doi:10.1089/pop.2013.0002

Cited by 96 publications

(85 citation statements)

References 19 publications

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“…Prior research on RRTs and ICU care transitions suggest that RRT team composition [35,36] and ICU liaison nurses (defined as dedicated registered nurses [RNs] who aid in post-ICU care transitions) might impact patient outcomes [37]. Trauma center status has also been shown to impact FTR [31,38] and is reflective of patient case mix at a given hospital [39]. Lastly, we asked about an ICU's capacity for rescue therapies such as extracorporeal membrane oxygenation (ECMO).…”

Section: Survey Instrumentmentioning

confidence: 99%

The association of intensivists with failure-to-rescue rates in outlier hospitals: Results of a national survey of intensive care unit organizational characteristics

Wakeam

Asafu-Adjei

Ashley

et al. 2014

Journal of Critical Care

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Section: Survey Instrumentmentioning

confidence: 99%

The association of intensivists with failure-to-rescue rates in outlier hospitals: Results of a national survey of intensive care unit organizational characteristics

Wakeam

Asafu-Adjei

Ashley

et al. 2014

Journal of Critical Care

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“…CMI provides a standard measure for comparing cumulative patient severity of illness and resource intensity across hospitals 30. The earlier study29 established the level of CPOE adoption at which the impact on LOS begins to accelerate (the tipping point) once the relationship is established.…”

Section: Introductionmentioning

confidence: 99%

Computerised Provider Order Entry Adoption Rates Favourably Impact Length of Stay

Schreiber¹,

Shaha

2016

jhi

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Background Research regarding return on investment for electronic health records (EHRs) is sparse. Objective To extend previously established research and examine rigorously whether increasing the adoption of computer-based provider/prescriber order entry (CPOE) leads to a decrease in length of stay (LOS), and to demonstrate that the two are inversely and bidirectionally proportional even while other efforts to decrease LOS are in place. Method The study assessed CPOE, LOS and case mix index (CMI) data in a community hospital in the United States, using a mature and nearly fully deployed vendor product EHR. CPOE rates and LOS over 7 years were determined on a per-patient, per-visit and per-discipline basis and compared with concomitant CMI data. Results An inverse relationship of CPOE to LOS was correlated for 13 disciplines out of 19, and organisation wide for all disciplines combined during the first 5 years of study. During the subsequent 2 years, both CPOE and LOS plateaued, except in eight disciplines where CPOE rates at first declined and LOS concurrently rose slightly, and then returned to the baseline plateau levels. CMI increased during the entire period of evaluation. An inflection point at approximately 60% CPOE adoption predicted the greatest improvement in lowering of LOS. Conclusions Rising and falling rates of CPOE correlated with reductions and rises in LOS, respectively. CPOE appeared statistically to be an independent factor in affecting LOS, over and above other efforts to shorten LOS, thus contributing to lower costs and improved efficiency outcomes as measured by LOS, even as CMI rises.

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“…Classifying institutions as poor-quality facilities have severe consequences for the physicians and staff. Determining the quality of documentation of the facility prior to classification could help to determine the accuracy of such classifications [6].…”

Section: Introductionmentioning

confidence: 99%

Impact of Electronic Health Record Documentation and Clinical Documentation Specialists on Case Mix Index: A Retrospective Study for Quality Improvement

Stacy¹

2014

J Health Med Informat

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Background: The implementation of hospital electronic health records software is considered a significant modernization in healthcare.Objective: The objective of this study was to evaluate the impact of electronic health records and the addition of clinical documentation specialists as a clinical support group on hospitalist documentation using case mix index (CMI) as a measurement tool. Methods:A two-group pre/postimplementation retrospective research design was used to evaluate the impact of electronic health records and clinical documentation specialists on CMI in a single 125-bed full-service community hospital in the greater Los Angeles area. All hospitalist medical records were reviewed in the pre/postphases. A total of 3,536 records were reviewed over the two phases. Phase one included a review of 1,712 hospitalist medical records before implementation of electronic health records. Phase two included a review of 1,824 hospitalist medical records after implementation of electronic health records and clinical documentation specialists. Change in CMI data were analyzed over the two phases. CMI data were treated as interval data and analyzed by parametric descriptive statistics in two phases by one-way ANOVA to compare the means between the two phases. Results:The mean CMI value for phase one was 1.65 and 1.68 for phase two. One-way ANOVA yielded no difference between the mean CMI values for the two phases (p.53). Conclusion:The implementation of electronic health records and clinical documentation specialists as a clinical support group did not make any significant difference in hospitalist documentation using CMI as a measurement tool.

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Impact of Hospital Variables on Case Mix Index as a Marker of Disease Severity

Cited by 96 publications

References 19 publications

The association of intensivists with failure-to-rescue rates in outlier hospitals: Results of a national survey of intensive care unit organizational characteristics

The association of intensivists with failure-to-rescue rates in outlier hospitals: Results of a national survey of intensive care unit organizational characteristics

Computerised Provider Order Entry Adoption Rates Favourably Impact Length of Stay

Impact of Electronic Health Record Documentation and Clinical Documentation Specialists on Case Mix Index: A Retrospective Study for Quality Improvement

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