case mix

(redirected from Case-mix)

case

 [kās]
a particular instance of a disease or other problem; sometimes used incorrectly to designate the patient with the disease.
case history the collected data concerning an individual, the family, and environment; it includes the medical history and any other information that may be useful in analyzing and diagnosing the case or for instructional or research purposes.
case method a type of nursing care delivery system; see nursing practice.
case mix the groups of patients requiring similar tests, procedures, and resources that are treated at a particular hospital. Case mix is a way to define a hospital's production and has been identified as a major factor in differing costs among hospitals and among individual patients.

case mix

A term which, as used in UK health planning circles, refers to the sum total of the diagnoses (diseases) present in a population, and high- and low-resource therapies required to manage them, considered as a single unit for the purpose of resource analysis and allocation planning.

case mix

Managed care The characteristics–age, gender and health status–of the population served by a health system or physician's office in a given period of time, which are classified by disease, diagnostic or therapeutic procedures performed, method of payment, duration of hospitalization, and intensity and type of services provided; in the US, a hospital's CM is based on the diagnosis-related groups. See Demographics, DRGs.

case mix

(kās miks)
The relative numbers of various types of patients being treated as categorized by disease-related groups, severity of illness, rate of consumption of resources, and other indicators; used as a tool for managing and planning health care services.
References in periodicals archive ?
It summarizes national trends surrounding complications and comorbidities (CC) and major complications and comorbidities (MCC) charge capture rates, and, includes case-mix index changes since the implementation of ICD-10.
These data were merged with case-mix data for Medicare patients calculated from the Outcome and Assessment Information Set (OASIS) for 2010 obtained from CMS.
And in all the countries that have introduced case-mix systems as a tool for management of health care it has provided more health for the money", Hansen said.
Nursing home case-mix indices (CMIs) are used by the CMS to adjust facility reimbursement based on the severity of resident illness in each facility in a given time.
"Measuring Case-Mix Complexity of Tertiary Care Hospitals Using D RG s." Healthcare Management Science 7 (1): 51-61.
The base payment rate would be adjusted for case-mix factors including patients age, body size, and time on dialysis.
To offset the potential increased costs associated with comorbidities and patient demographic factors, MMA-2003 also required that the new reimbursement program include a limited number of patient-specific case-mix adjusters (such as comorbidities and patient demographic factors) to allow higher reimbursement for patients who required more resource-intensive care (CMS, 2003).
A special case-mix adjustment would apply to pediatric patients.
So, says a CMS press release, "Taken together with the proposed recalibration of the CMI, (that's governmentese for "case-mix index"), SNFs could expect to see a slight decrease in payments of $60 million, or 0.3%."
One way to address this problem is through case-mix classification systems that allocate hours of care according to client needs.
Finally, the case-mix controls varied widely by the sample drawn and should not be used to infer prevalence of these conditions in the Medicaid and State Employees Health Plan populations.