RELATIONSHIP BETWEEN SEVERITY, COSTS AND CLAIMS OF HOSPITALIZED-PATIENTS USING THE SEVERITY OF ILLNESS INDEX

The results of the prospective application of Kern's 'Severity of Illn ess Index' in a teaching hospital during 1987, 1989, and 1990 constitu te the basis of the present report. The average overall severity of il lness scores for the three years were 1.42 in 1987, 1.65 in 1989, and 1.46 in 1990. Most of the processes evaluated in the three periods sho wed an overall distribution among severity levels 1 and 2, both overal l and when the seven dimensions of the severity of illness index were analyzed. A statistically significant correlation between the overall severity of illness and average length of stay was found for patients in 1989 and 1990. The length of stay differed significantly in the dif ferent severity levels. When the four levels of the seven dimensions o f the severity of illness index for 1987, 1989, and 1990 were compared , it was observed that figures were not uniformly distributed. There w as a statistically significant association between severity of illness for hospital service and pharmacy charges per hospital stay for both 1989 and 1990, as well as a statistically significant inverse relation ship between severity of illness and the number of claims per hospital service in both periods of time. Case-mix methods that account for th e severity of patients constitute a useful indicator of quality for th e management of different hospital services and of the hospital as a w hole.