RUG-III AND RESOURCE-ALLOCATION - COMPARING THE RELATIONSHIP OF DIRECT-CARE TIME WITH PATIENT CHARACTERISTICS IN 5 COUNTRIES

Background: resource use by different types of patients is of increasi ng interest to health care services all over the world. Case-mix syste ms that group together individuals with similar patterns of resource u se have been developed to address these questions. Resource Utilizatio n Groups version III (RUG-III) was developed in the USA to address the issue in the care of elderly people and has been validated in a numbe r of countries. Method: this paper synthesizes the results of RUG-III validation studies performed in the USA, Japan, Spain, Sweden and Engl and and Wales, showing the consistency of the system in spite of diffe rent skill-mix and total time spent with patients. Data from the valid ation studies of five countries were compared. Percentage of time give n by trained nurses and mean nursing time per patient was compared ove rall and between selected RUG-III groups. Results: mean time per patie nt ranged from 84.4 min per day in Japan, to 155.6 min in England and Wales. Trained nurse time ranged from 7.5% of total time in the USA to 53.2% of total time in England and Wales. The inter-group relationshi p was very similar in all countries. The RUG-III system appears robust in a wide variety of settings and countries. Future research should a ddress the relationship between skill-mix and total time spent with pa tients with respect to outcome and quality of care.