Casemix for The Elderly Inpatient: Resource Utilization Groups (RUGs) Validation Project

Abstract

Current methods of contracting for patient treatment in the health service are not suitable for elderly patients with multiple pathology and functional impairment. This study examines Resource Utilization Groups (RUGs) for use in geriatric medicine in England and Wales, based on 1675 patients from 26 hospitals in eight health districts in England and Wales. Nurses completed a questionnaire on the clinical characteristics of patients required to allocate them to one of 44 RUG groups. Nurse/patient contact times were recorded over a 24-hour period. Therapist/patient contact times were recorded for a week. Data were analysed using analysis of variance with time as independent and RUG group as dependent variable. Variance explanation in excess of 45% was achieved in acute and rehabilitation wards. In long-stay wards, variance explanation (23%) was no better than ADL score alone. RUG-III could form the basis of a casemix system for geriatrics in England and Wales in acute and rehabilitation settings.

Validity, reliability and clinical feasibility of a Needs Assessment Tool for people with progressive cancer

“…Information about the palliative care service, the person receiving care and their clinical characteristics is collected [19]. The AKPS, RUG-ADL and PCPSS are part of the PCOC data set collected on every person referred to participating SPCSs with each clinical encounter, and have been shown to be both reliable and valid [15,18,23,24].…”

Evaluación de 1.497 adultos mayores institucionalizados, usando el «sistema de clasificación de pacientes RUG T-18»

“…Bajo este marco, se pueden analizar los resultados encontrados usando RUG T-18 como método de clasificación de los pacientes, método validado internacionalmente y utilizado previamente en la evaluación de AM tanto institucionalizados como en otros contextos [8][9][10] . Es importante destacar que la muestra es de una magnitud suficiente para darle validez a los resultados y extrapolarlos a poblaciones que compartan la mayoría de los criterios de ingreso descritos.…”

“…Existen dos grandes grupos de sistemas de clasificación de pacientes, los que dependen del diagnóstico, denominados «Disease Related Groups -DRGs» y los que son independientes del diagnóstico, llamados «Resources Utilization Groups -RUGs» 9 .…”

“…El sistema RUG T-18 ha sido validado internacionalmente para ser usado en el contexto de residencias de larga estancia de AM 7-9 y en Chile fue ya usado por nuestro grupo en AM hospitalizados 10 . Este instrumento es útil, tanto para describir mejor una población de AM, como para optimizar los sistemas administrativos de admisión del paciente o el tipo, tiempo y dedicación del personal requerido, y los otros recursos económi-cos, con el fin de lograr una mejor atención al paciente [7][8][9][10] .…”

Casemix and rehabilitation: evaluation of an early discharge scheme

“…The Modified Barthel Index (Williams and Shah 1995) the Functional Index Measure (Lee et al 1994) and Resource Utilisation Groups (Carpenter, Main, & Turner 1995) were considered but each had limitations. These related to difficulties assessing functional return across the environments of acute care, rehabilitation unit, community centre and home.…”