Ambulatory visit groups

Lion, Joanna; Malbon, Alan; Bergman, Alicia A.

doi:10.1097/00004479-198702010-00006

Journal of Ambulatory Care Management

1987

DOI: 10.1097/00004479-198702010-00006

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Ambulatory visit groups

Joanna Lion¹,

Alan Malbon²,

Alicia A. Bergman³

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Cited by 9 publications

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Medical Care Classification Systems in the ambulatory care environment: An evaluative framework

Denis

1990

J Med Syst

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An essential need of a Quality Assurance Program (QAP) in an ambulatory care setting is accurate and reliable information characterizing the encounter between patient and provider. This information includes identification of the patient's reason for visit, the provider's diagnostic impressions, and procedures performed. Such data can be used to maintain an informational index on the nature of patient care. Based upon this index, a wide variety of special studies in the assessment and assurance of the quality of care can be conducted. A primary consideration in the development of such an index is the choice of a Medical Care Classification System (MCCS) to be used to code encounter-related data. The objective of this paper is to provide a methodology and evaluative framework in which available Medical Care Classification Systems can be assessed as to which one best meets the needs of the quality assurance programs within ambulatory care settings.

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Medical Care Classification Systems in the ambulatory care environment: An evaluative framework

Denis

1990

J Med Syst

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Looking at the patient in the mix: Is case mix methodology unfair to the hospital outpatient department?

Fein

Hoffman²,

Barzel³

1988

J Gen Intern Med

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The diagnoses of 431 general internal medicine patients from an urban outpatient department (OPD) were analyzed using two methods of case mix description: 1) a visit-based method which captures a single diagnosis for each visit; 2) a patient-based method which captures multiple diagnoses for a patient over one year. Nine of the top ten diagnoses were the same using either method, but the prevalence of diagnoses was two- to twelvefold higher with the patient-based method. Next the OPD was compared by the visit-based method with a national survey of doctors' private offices. Although the visit-based case mix in the OPD appeared to be the same as that in doctors' private offices, the analysis suggested that differences may be hidden by the method of describing case mix. The authors conclude that a visit-based approach to case mix description makes urban OPDs resemble doctors' private offices because the visit-based method undercounts those patients with chronic diagnoses, co-morbid conditions, and psychosocial problems, so common in the urban OPD. These findings have major implications for ambulatory reimbursement schemes, most of which capture only one diagnosis for each visit.

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Ambulatory care casemix measures

Berlowitz

Rosen²,

Moskowitz³

1995

J Gen Intern Med

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Ambulatory visit groups

Cited by 9 publications

References 1 publication

Medical Care Classification Systems in the ambulatory care environment: An evaluative framework

Medical Care Classification Systems in the ambulatory care environment: An evaluative framework

Looking at the patient in the mix: Is case mix methodology unfair to the hospital outpatient department?

Ambulatory care casemix measures

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