The Computerized Severity Index
Journal of Medical SystemsPublished 1 February 1986
Susan D. Horn, Roger A. Horn
Citations60
SJR quartileQ1
SJR score0.96
SNIP1.52
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TL;DR
The new Computerized Severity Index (CSI) that is obtained from an expanded discharge abstract data set, based on a 6th-digit severity addition to the ICD-9-CM coding system is described.
Abstract
We describe the new Computerized Severity Index (CSI) that is obtained from an expanded discharge abstract data set, based on a 6th-digit severity addition to the ICD-9-CM coding system. The new 6-digit code book (called ICD-9-CMSA) is used to label existence and severity of each principal and secondary diagnosis. It can be used to produce an overall severity of illness level for each hospital inpatient. The impact of severity-adjusted DRGs on prospective payment and uses of the CSI for assessing quality of care, efficiency, physician practice profiles, and prediction of posthospital resource needs are discussed.
Keywords
MedicineHealth Professions
New England Journal of MedicineInterhospital Differences in Severity of Illness
183 Citations1985Susan D. Horn, Gregory B. Bulkley +4 more
It is suggested that patient classification by means of unadjusted DRGs does not adequately reflect severity of illness, and prospective payment programs based on DRGs alone may unfairly and adversely discriminate against certain hospitals.
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146 Citations1983Susan D. Horn, Phoebe D. Sharkey +1 more
It is found that this index, which takes into account patient severity of illness, produces groups that are more homogeneous than those produced by four other case mix grouping methods that do not reflect the total burden of the patient's illness.
Medical CareReliability and Validity of the Severity of Illness Index
108 Citations1986Susan D. Horn, Roger A. Horn
The conclusion is that the Severity of Illness Index is a reliable and valid tool for measuring inpatient severity of illness.
American Journal of Public HealthMeasuring Severity of Illness: Comparisons Across Institutions
107 Citations1983Susan D. Horn
American Journal of Public HealthSeverity of illness within DRGs: impact on prospective payment.
91 Citations1985Susan D. Horn, Phoebe D. Sharkey +2 more
The findings suggest that, with a more representative set of hospitals, the difference between unadjusted and Severity-adjusted DRG-based prospective payment could be greater than 35 per cent of a hospital's total operating costs.
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85 Citations1984Sebastian Horn, Roger A. Horn +1 more
This article discusses the Severity of Illness case-mix groups, and suggests a refinement to diagnosis-related groups (DRG's) designed to accommodate the important element of patient severity, which is presented in a discussion of the efficient production of hospital services.
Medical CareSeverity of Illness Within DRGs
59 Citations1986Susan D. Horn, Roger A. Horn +2 more
The findings indicate that the phenomenon of severity of illness differences within DRGs, and the corresponding differences in resource use, is consistent across 15 hospitals that represent all sections of the United States and all teaching types.
Medical CareDRGs and Disease Staging for Reimbursing Medicare Patients
44 Citations1986Rosanna M. Coffey, Marsha G. Goldfarb
Surprisingly, large hospitals (including urban, not-for-profit, teaching hospitals) fare better under a DRG-based reimbursement system than under Disease Staging, a severity-of-illness system that excludes procedures as a basis of classification.
Psychiatric ServicesChallenges in Bringing Exempt Psychiatric Services Under a Prospective Payment System
25 Citations1985Stephen F. Jencks, Howard H. Goldman +1 more
The authors review the criteria and methods for evaluating a psychiatric prospective payment system and suggest ways that the current classification and payment systems can be improved.
Medical CareThree Case-Type Classifications: Suitability for Use in Reimbursing Hospitals
19 Citations1982Richard Ament, Janice L. Dreachslin +2 more
This study compared three case-type classifications and found that none of the currently available classifications accounts for enough variance to permit straightforward use of case- type standard costs in a reimbursement mechanism.
American Journal of Public HealthProfiles of physician practice and patient severity of illness.
17 Citations1986Susan D. Horn, Roger A. Horn +1 more
The findings that 37 per cent of the physicians in the study may be wrongly identified as over- or under-utilizers suggest long-term public health consequences of preparing physician profiles based on unadjusted DRGs.