CoChat
Sign Up
Cited by 130Healthcare Policy and ManagementMedical Coding and Health InformationHealthcare Quality and Management

The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.

Impact of Hospital Variables on Case Mix Index as a Marker of Disease Severity

Open access
Mendez, Carmen M., Harrington, Darrell W., Christenson, Peter, Spellberg, Brad·2014·Population Health Management
DOI 10.1089/pop.2013.0002PMC PMC3931432
Open this paper in CoChat — free account

Abstract

Case mix index (CMI) has become a standard indicator of hospital disease severity in the United States and internationally. However, CMI was designed to calculate hospital payments, not to track disease severity, and is highly dependent on documentation and coding accuracy. The authors evaluated whether CMI varied by characteristics affecting hospitals' disease severity (eg, trauma center or not). The authors also evaluated whether CMI was lower at public hospitals than private hospitals, given the diminished financial resources to support documentation enhancement at public hospitals. CMI data for a 14-year period from a large public database were analyzed longitudinally and cross-sectionally to define the impact of hospital variables on average CMI within and across hospital groups. Between 1996 and 2007, average CMI declined by 0.4% for public hospitals, while rising significantly for private for-profit (14%) and nonprofit (6%) hospitals. After the introduction of the Medicare Severity Diagnosis Related Group (MS-DRG) system in 2007, average CMI increased for all 3 hospital types but remained lowest in public vs. private for-profit or nonprofit hospitals (1.05 vs. 1.25 vs. 1.20; P <0.0001). By multivariate analysis, teaching hospitals, level 1 trauma centers, and larger hospitals had higher average CMI, consistent with a marker of disease severity, but only for private hospitals. Public hospitals had lower CMI across all subgroups. Although CMI had some characteristics of a disease severity marker, it was lower across all strata for public hospitals. Hence, caution is warranted when using CMI to adjust for disease severity across public vs. private hospitals. ( Population Health Management 2014;17:28–34)

Overview

Integrity signals

Registry

Crossref · 10.1089/pop.2013.0002

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Flagged first, then by citations

Show all 22 references

Research works printed but not linked: 3

  1. Documentation initiative increases case mix index. Hosp Case Manag, 2008; 16:156–158.
  2. Carey RG, , Lloyd RC. Measuring Quality Improvement in Healthcare. Milwaukee, WI: Quality Press; 2001.
  3. Spellberg B. Solving the antibiotic crisis: A top down strategic rethink. Presented at: Facilitating Antibacterial Drug Development, Brooking's Institute, Engelberg Center for Health Care Reform, May 9, 2012, Washington, DC.

Cited by

Sorted by citations

Items 101–130 of 130

Related

See all

Metadata

Authors
Mendez, C. M., Harrington, D. W., Christenson, P., & Spellberg, B.
Affiliations
University of California, Los Angeles (US)
Corresponding author
Spellberg, Brad
ORCID
Spellberg, Brad
Venue
Population Health Management
Publisher
SAGE Publications
Published
2014-02
Volume
17
Issue
1
Pages
28-34
ISSN
  • 1942-7891 (ISSN-L)
  • 1942-7905
DOI
10.1089/pop.2013.0002
PMC
PMC3931432
OpenAlex
W2335477057
Cited by
130
References
22
Citations by year
2026: 13 · 2025: 12 · 2024: 8 · 2023: 9 · 2022: 18 · 2021: 16 · 2020: 9 · 2019: 12 · 2018: 13 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 5
FWCI
11.74
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Population Health Management (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (UL1TR000124)
  • National Center for Advancing Translational Sciences
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
Keywords
case mix index, disease severity, public hospitals, private hospitals, teaching hospitals, trauma centers, hospital size, hospital reimbursement, hospital type comparison
MeSH terms
Cross-Sectional Studies, Diagnosis-Related Groups, Hospitals, Public, Humans, Prospective Payment System, Severity of Illness Index, United States, Centers for Medicare and Medicaid Services, U.S., Databases, Factual, Hospitals, Private, Clinical Coding

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review