Severity of illness and diagnostic formulation: Classifying patients for prospective payment systems

J. E. Mezzich, S. S. Sharfstein

Research output: Contribution to journalArticlepeer-review

Abstract

Before any of the innovative procedures proposed - especially the severity-of-illness coding schema - are implemented, their reliability and usefulness should be empirically appraised. The vulnerability of the resource consumption prediction system to misuse by inflating the seriousness of the patient's condition should also be examined. Such 'gaming' is possible in any system based on diagnostic judgments, but it may be minimized by increasing the specificity and documentability of the diagnostic formulation. The assessments outlined in this paper, particularly the extended coding for indicating severity of psychiatric disorder and other direct changes in DSM-III, could be made at the initial evaluation point before formal treatment is started. Such assessments would enhance prediction of clinical care utilization, improve the method of formulating psychiatric diagnoses, and ensure that data pertinent to resource consumption are routinely obtained and recorded in clinical charts.

Original languageEnglish (US)
Pages (from-to)770-772
Number of pages3
JournalHospital and Community Psychiatry
Volume36
Issue number7
DOIs
StatePublished - 1985

ASJC Scopus subject areas

  • Psychiatry and Mental health

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