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The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinating authority for health within the United Nations System. The ICD is originally designed as a health care classification system, providing a system of diagnostic codes for classifying diseases, including nuanced classifications of a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. This system is designed to map health conditions to corresponding generic categories together with specific variations, assigning for these a designated code, up to six characters long. Thus, major categories are designed to include a set of similar diseases.
Case mix, also casemix and patient mix, is a term used within healthcare as a synonym for cohort; essentially, a case mix groups statistically related patients. An example case mix might be male patients under the age of 50, who present with a myocardial infarction and also undergo emergency coronary artery bypass surgery.
In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity - is the presence of one or more additional conditions often co-occurring with a primary condition. Comorbidity describes the effect of all other conditions an individual patient might have other than the primary condition of interest, and can be physiological or psychological. In the context of mental health, comorbidity often refers to disorders that are often coexistent with each other, such as depression and anxiety disorders. The concept of multimorbidity is related to comorbidity but presents a different meaning and approach.
A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, which are used to track diseases and other health conditions, inclusive of chronic diseases such as diabetes mellitus and heart disease, and infectious diseases such as norovirus, the flu, and athlete's foot. Procedure classifications list procedure code, which are used to capture interventional data. These diagnosis and procedure codes are used by health care providers, government health programs, private health insurance companies, workers' compensation carriers, software developers, and others for a variety of applications in medicine, public health and medical informatics, including:
APACHE II is a severity-of-disease classification system, one of several ICU scoring systems. It is applied within 24 hours of admission of a patient to an intensive care unit (ICU): an integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death. The first APACHE model was presented by Knaus et al. in 1981.
Perioperative mortality has been defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital. Globally, 4.2 million people are estimated to die within 30 days of surgery each year. An important consideration in the decision to perform any surgical procedure is to weigh the benefits against the risks. Anesthesiologists and surgeons employ various methods in assessing whether a patient is in optimal condition from a medical standpoint prior to undertaking surgery, and various statistical tools are available. ASA score is the most well known of these.
The pneumonia severity index (PSI) or PORT Score is a clinical prediction rule that medical practitioners can use to calculate the probability of morbidity and mortality among patients with community acquired pneumonia.
A pain scale measures a patient's pain intensity or other features. Pain scales are a common communication tool in medical contexts, and are used in a variety of medical settings. Pain scales are a necessity to assist with better assessment of pain and patient screening. Pain measurements help determine the severity, type, and duration of the pain, and are used to make an accurate diagnosis, determine a treatment plan, and evaluate the effectiveness of treatment. Accurately measuring pain is a necessity in medical settings, especially if the pain measurement is going to be used as a screening tool, either for potential diseases or medical problems, or as a type of triage to determine urgency of one patient over another. Pain scales are based on trust, cartoons (behavioral), or imaginary data, and are available for neonates, infants, children, adolescents, adults, seniors, and persons whose communication is impaired. Pain assessments are often regarded as "the 5th Vital Sign".
In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. Integrated delivery systems where insurers and providers share in the cost are intended to help align incentives for value-based care.
The sequential organ failure assessment score, previously known as the sepsis-related organ failure assessment score, is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.
Surgical Outcomes Analysis & Research, SOAR, is a research laboratory of the Department of Surgery at Boston University School of Medicine and Boston Medical Center with expertise in outcomes research. SOAR investigates surgical diseases and perioperative outcomes. The group focuses on pancreatic cancer, other gastrointestinal and hepatobiliary malignancies, vascular disease, and transplant surgery. SOAR's goal is to examine quality, delivery, and financing of care in order to have an immediate impact on patient care and system improvements. The group members utilize national health services and administrative databases, as well as institutional databases, to investigate and to address factors contributing to disease outcomes and healthcare disparities.
The Healthcare Cost and Utilization Project is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
Trauma in children, also known as pediatric trauma, refers to a traumatic injury that happens to an infant, child or adolescent. Because of anatomical and physiological differences between children and adults the care and management of this population differs.
Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for screening and severity measuring of generalized anxiety disorder (GAD). GAD-7 has seven items, which measure severity of various signs of GAD according to reported response categories with assigned points. The GAD-7 items include: 1) nervousness; 2) inability to stop worrying; 3) excessive worry; 4) restlessness; 5) difficulty in relaxing; 6) easy irritation; and 7) fear of something awful happening. Assessment is indicated by the total score, which is made up by adding together the scores for the scale of all seven items. The GAD-7 was originally validated in a primary care sample and a cutoff score of 10 had a sensitivity value of 0.89 and a specificity value of 0.82 for identifying GAD. The authors of the questionnaire also found acceptable sensitivity and specificity values when the questionnaire was used as a general screen to identify other anxiety disorders.
The Baux score is a system used to predict the chance of mortality due to burns. The score is an index which takes into account the correlative and causal relationship between mortality and factors including advancing age, burn size, the presence of inhalational injury. Studies have shown that the Baux score is highly correlative with length of stay in hospital due to burns and final outcome.
The Patient Activation Measure (PAM) is a commercial product which assesses an individual's knowledge, skill, and confidence for managing one's health and healthcare. Individuals who measure high on this assessment typically understand the importance of taking a pro-active role in managing their health and have the skills and confidence to do so.
The Trauma Quality Improvement Program (TQIP) was initiated in 2008 by the American College of Surgeons Committee on Trauma. Its aim is to provide risk-adjusted data for the purpose of reducing variability in adult trauma outcomes and offering best practice guidelines to improve trauma care. TQIP makes use of national data to allows hospitals to objectively evaluate their trauma centers' performance relative to other hospitals. TQIP's administrative costs are less than those of other programs, making it an accessible tool for assessing performance and enhancing quality of trauma care.
James X. Zhang is an American health economist and health services researcher at the University of Chicago known for his innovative approaches in exploring complex data to measure a range of factors influencing healthcare delivery and outcomes.
In medicine, the Charlson Comorbidity Index (CCI) predicts the mortality for a patient who may have a range of concurrent conditions (comorbidities), such as heart disease, AIDS, or cancer (considering a total of 17 categories). A score of zero means that no comorbidities were found; the higher the score, the higher the predicted mortality rate is. For a physician, this score is helpful in deciding how aggressively to treat a condition.
In medicine, the Comorbidity–polypharmacy score (CPS) is a measure of overall severity of comorbidities. It is defined as the simple sum of the number of known comorbidities and pre-admission medications taken by the patient (polypharmacy), as a surrogate for the “intensity” of the comorbidities.
References
- 1 2 Elixhauser, A.; Steiner, C.; Harris, D. R.; Coffey, R. M. (January 1998). "Comorbidity measures for use with administrative data". Medical Care. 36 (1): 8–27. doi:10.1097/00005650-199801000-00004. ISSN 0025-7079. PMID 9431328.
- 1 2 Van Walraven, Carl; Austin, Peter C.; Jennings, Alison; Quan, Hude; Forster, Alan J. (2009). "A Modification of the Elixhauser Comorbidity Measures into a Point System for Hospital Death Using Administrative Data". Medical Care. 47 (6): 626–33. doi:10.1097/MLR.0b013e31819432e5. PMID 19433995. S2CID 35832401.
- ↑ Garland A, Fransoo R, Olafson K, Ramsey C, Yogendran M, Chateau D, McGowan K. The Epidemiology and Outcomes of Critical Illness in Manitoba . Winnipeg, MB: Manitoba Centre for Health Policy, 2012
- ↑ "Charlson Comorbidity Index (CCI) – Strokengine" . Retrieved 2023-03-25.
- ↑ Sharabiani, Mansour; Aylin, Paul; Bottle, Alex (December 2012). "Systematic review of comorbidity indices for administrative data". Medical Care. 50 (12): 1109–18. doi:10.1097/MLR.0b013e31825f64d0. PMID 22929993. S2CID 25852524.