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Mendenhall S. DRG’s must be changed to take patient’s illness severity into account. Modern Health Care 1984; Nov 15:86–8.
Muller C. Paying hospitals: how does a severity measure help (editorial). Am J Public Health 1983;73:14–5.
Eisenberg BS. Diagnosis-related groups, severity of illness and equitable reimbursement under Medicare (editorial). JAMA 1984;25:645–6.
Schweiker RS. Report to Congress. Hospital prospective payment for Medicare. Department of Health and Human Services. 1982; Dec:1–107.
Horn SD, Bulkley G, Sharkey PD, Chambers AF, Horn RA, Schramm CJ. Interhospital differences in severity of illness. Problems for prospective payment based on diagnosis-related groups (DRGs). N Engl J Med 1985;313:20–4.
Smits HL, Fetter RB, McMahon LF. Variation in resource use within diagnosis-related groups: the severity issue. Health Care Financing Review. 1984; (suppl) Nov: 71–8.
Leikin JB, Polin KS, Schiff RL, et al. Transfers to a public hospital: a prospective study of 467 patients. N Engl J Med 1986;315:552–7.
McMahon LF. Diagnosis-related groups prospective payment: effects on medical quality assurance. Evaluation and the Health Professions 1984;7:24–41.
Griner PF, Liptzen B. Use of the laboratory in a teaching hospital: the implication for patient care education, and hospital costs. Ann Intern Med 1971;75:157–63.
Linn LS, Yager J, Leake BD, Gastaldo G, Palkowski O. Differences in the numbers and costs of tests ordered by internists, family physicians, and psychiatrists. Inquiry 1984;22:266–75.
Eisenberg JM. Physician utilization. The state of research about physician’s practice patterns. Med Care 1985;23:461–83.
Cornell FA, Blide LA, Hanken MA. Clinical correlates of small area variation in population-based admission rates for diabetes. Med Care 1984;22:939–49.
Wennberg JE, Gittleson A. Variations in medical care among small areas. Sci Am 1982;120–34.
Wennberg JE, McPhearson K, Caper P. Will payment based on diagnosis-related groups control hospital costs? N Engl J Med 1984;311:295.
Stockwell H, Vayda E. Variations in surgery in Ontario. Med Care 1979;17:390–6.
Roos LL, Roos NP. Assessing existing technologies: the Manitoba study of common surgical procedures. Med Care 1983;21:454–62.
Horn SD, Horn RA, Sharkey PD. The Severity of Illness Index as a severity adjustment to diagnosis related groups. Health Care Financing Rev 1984;(suppl):33–45.
McMahon LF, Newbold R. Variation in resource use within diagnosis related groups: the effect of severity of illness and physician practice. Med Care 1986;24:388–97.
Fetter RB, Shin Y, Freeman JL, Averill RF, Thompson JD. Case mix definition by diagnosis-related groups. Med Care 1980;(suppl) 18:1–53.
Health Systems Management Groups. The new ICD-9-CM diagnosis related group classification scheme. Final report. United States Department of Health and Human Servies. Health Care Financing Administration Publication #03167, September 1984.
Uniform hospital discharge data; minimum data set. Report to the National Committee on Vital Health Statistics, DHEW Pub. No. PHS 80–1157.
Commission on Professional Hospital Activities. ICD-9-CM international classification of diseases, 9th revision, clinical modification. Ann Arbor, MI: Commission on Professional Hospital Activities, 1978.
McMahon LF, Smits HL. Can the Medicare prospective payment system survive the ICD-9-CM disease classification system? Ann Intern Med 1986;104:562–6.
Mullin RL. Diagnosis-related groups and severity: ICD-9-CM, the real problem. JAMA 1985;254:1208–10.
Gertman PM, Lowenstein S. A research paradigm for severity of illness: issues for the diagnosis-related group system. Health Care Financing Rev 1984; (suppl), 85.
Young WW. Incorporating severity of illness and comorbidity in casemix measurement. Health Care Financing Rev 1984; (suppl):23–31.
Young WW, Swinkola RB, Zurn DM. The measurement of hospital case mix. Med Care 1982;20:501–12.
Roveti GC, Horn SD, Kreitzer SL. “AS-SCORE”: a multi-attribute clinical index of illness severity. Quality Rev Bull 1980; July; 25–31.
Horn SD, Horn RA. Reliability and validity of the severity of illness index. Med Care 1986;24:159–78.
Horn SD. Measuring severity of illness: comparisons across institutions. Am J Public Health 1983;73:25–31.
Horn SD, Sharkey PD. Measuring severity of illness to predict resource use within DRGs. Inquiry 1983;20:314–21.
Horn SD, Sharkey PD, Bertram D. Measuring severity of illness: homogeneous case-mix groups. Med Care 1983;21:14–31.
Horn SD, Horn RA, Sharkey PD, Chambers AF. Severity of illness within DRG’s homogeneity study. Med Care 1986;24:225–35.
Schumacher DN, Parker B, Kofie V, Munns JM. Severity of Illness Index and the Adverse Patient Occurrence Index: a reliability study and policy implications. Med Care 1987;25:695–704.
Jenks SF, Dobson A, Willis P, Feinstein PH. Evaluating and improving the measurement of hospital case mix. Health Care Financing Rev 1984;(suppl):1–11.
Horn SD. Measuring severity: how sick is sick? How well is well. HealthCare Financial Management October 1986, 21–32.
Backofen J, Ashworth MA, Horn SD. The computerized severity of index. A new sophisticated tool to measure hospital quality of care. HealthCare Form, March/April 1987, 35–37.
Gonella JS, Louis DZ, McCord JJ. The staging concept—an approach to the assessment of outcome of ambulatory care. Med Care 1976;14:13–21.
Gonella JS, Hornbrook MC, Louis DZ. Staging of disease: a case-mix measurement. JAMA 1984;637–44.
Systemetrics Inc. Disease staging: a clinically based approach to measurement of disease severity, Vol 1. Executive Summary National Technical Information Service: PB 83-254656. 1983:(Aug):1–25.
Kelly JV, Hellinger FJ. Physician and hospital factors associated with mortality of surgical patients. Med Care 1986;24:785–800.
Conklin JE, Lieberman JV, Barnes CA, Louis DZ. Disease staging: implications for hospital reimbursement and management. Health Care Financing Rev 1984;(suppl):13–22.
Coffey RM, Goldfarb MG. DRGs and disease staging for reimbursing Medicare patients. Med Care 1986;24:814–29.
Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE. APACHE—Acute Physiology and Chronic Health Evaluation: a physiologically based classification system. Crit Care Med 1981;9:591–7.
Wagner DP, Draper EA. Acute Physiology and Chronic Health Evaluation (APACHE II) and Medicare reimbursement. Health Care Financing Rev 1984;(suppl):91–105.
Wagner DP, Knaus WA, Draper EA. Statistical validation of a severity of illness measure. Am J Public Health 1983;73:878–84.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med 1986;104:410–8.
Brewster AC, Jacobs CM, Bradbury RC. Classifying severity of illness by using clinical findings. Health Care Financing Rev (suppl) 1984; 107–8.
Brewster AC, Karlin BG, Hyde LA, Jacobs CM, Bradbury RC, Chac YM. MEDISGRPS®: a clincally based approach to classifying hospital patients at admission. Inquiry 1985;22:377–87
Ieezzoni LI, Ash AS, Moskowitz MA. MEDISGRPS®: a clinical analytic assessment. Waltham, MA: Health Policy Research Consortium. 1987.
Calore KA, Iezzoni L. Disease staging and PMCs: can they improve DRGs? Med Care 1987;25:724–35.
Thomas JW, Ashcraft MLF, Zimmerman J. An evaluation of alternative severity of illness measures for use by university hospitals. Ann Arbor, MI: Department of Health Services Management and Policy, School of Public Health, University of Michigan, 1986.
Jenks SF, Dobson A. Refining case-mix adjustment: the research evidence. N Engl J Med 1987;317:679–86.
Prospective Payment Assessment Commission. Medicare prospective payment and the American health care system report to Congress. February 1986; 19.
Levit KR, Lazenby H, Waldo DR, Davidoff LM. National health expenditures. 1984. Health Care Financing Rev 1985;7:1–35.
Shapiro MF, Larson EB. Funding for medical care research. J Gen Intern Med 1987;2:113–8.
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Received from the Departments of Internal Medicine and Health Services Management and Policy, University of Michigan. Ann Arbor, Michigan.
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McMahon, L.F., Billi, J.E. Measurement of severity of illness and the medicare prospective payment system. J Gen Intern Med 3, 482–490 (1988). https://doi.org/10.1007/BF02595926
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DOI: https://doi.org/10.1007/BF02595926