Recruitment and retention--a "top end" experience.
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Fellowships and Scholarships↗
Biomedical subjects
A Morrison
Publications and source records attributed to A Morrison.
New guidelines for treating major depression.
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Adult↗
[Limitations of case-mix systems in primary care: comparison of the severity of patients in community hospitals and health care centers in the United States].
OBJECTIVE: The aim was to show the limitations of the case-mix "based on attendance", which take into account neither the seriousness of the diagnoses nor the comorbidity. DESIGN: A crossover descriptive study of a retrospective nature. SETTING: In New York, in two centres located in the Hispanic community of Upper Manhattan and a third in the Presbyterian Hospital. PARTICIPANTS: During 1991, 225 patients were studied: 150 attended in the hospital PCC and 75 in the non-hospital PCCs. A simple random sampling of the list of patients attended was performed. INTERVENTIONS: The seriousness of the conditions of the patients attended in the two different types of PCC was compared through the Duke Severity of Illness Scale (DUSOI), a patient-based case-mix which assesses the level of seriousness of each individual diagnosis and the comorbidity linked to the diagnoses grouped together. MEASUREMENTS AND MAIN RESULTS: Significant differences between the seriousness of the conditions of the patients in the two sub-samples were found when comparison by means of bivariant analysis was performed. Scoring on the Severity Scale was significantly higher for those attending hospital (65.5 and 55.1 respectively). CONCLUSIONS: Patient classification systems based on the reasons for attendance underestimate the seriousness of the condition. A case-mix in which the patient is the unit of analysis needs to be developed.
Community Health Services↗