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 accessAbstract
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)
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“we adopted the notion of the CMI3,25, which is an averaged score of DRG weights given a patient group.”
From Early prediction of diagnostic-related groups and estimation of hospital cost by processing clinical notes (2021) · cites this paper as [3]
In the citing paper
“Hospital operation managers may review quarterly or even monthly DRG-based statistics to assess its patient mix3,4 and financial efficiency5,6 under DRG reimbursement.”
From Early prediction of diagnostic-related groups and estimation of hospital cost by processing clinical notes (2021) · cites this paper as [3]
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Gandra, S., Alvarez‐Uria, G., Turner, P., Joshi, J., Limmathurotsakul, D., & van Doorn, H. R. (2020) · Clinical Microbiology Reviews · doi:10.1128/cmr.00048-19 · Cited by 297
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Asrani, S. K., Kouznetsova, M., Ogola, G., Taylor, T. J., Masica, A. L., Pope, B., Trotter, J. F., Kamath, P. S., & Kanwal, F. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.05.032 · Cited by 122
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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
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
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