Case mix 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 myo ...

index (CMI) within

health care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health pr ...

and

medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...

, is a relative value assigned to a

diagnosis-related group Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups, with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collabora ...

of patients in a medical care environment. The CMI value is used in determining the allocation of resources to care for and/or treat the patients in the group.

Resource Use Groups

Patients are classified into groups having the same condition (based on main and secondary diagnosis, procedures, age), complexity (

comorbidity In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary ...

) and needs. These groups are known as Diagnosis Related Groups (DRG), or

Resource Use Groups Resource refers to all the materials available in our environment which are technologically accessible, economically feasible and culturally sustainable and help us to satisfy our needs and wants. Resources can broadly be classified upon their a ...

(RUG). Each DRG has a relative average value assigned to it that indicates the amount of resources required to treat patients in the group, as compared to all the other diagnosis-related groups within the system. The relative average value assigned to each group is its CMI.

Hospital CMI

The CMI of a hospital reflects the diversity, clinical complexity and the needs for resources in the population of all the patients in the hospital. The CMI value of a hospital can be used to adjust the average cost per patient (or per day) for a given hospital relative to the adjusted average cost for other hospitals by dividing the average cost per patient (or day) by the hospital's calculated CMI. The adjusted average cost per patient would reflect the charges reported for the types of cases treated in that year. If a hospital has a CMI greater than 1.00, their adjusted cost per patient or per day will be lower and conversely if a hospital has a CMI less than 1.00, their adjusted cost will be higher. ''Example:'' A link to the 2011 spreadsheet of the CMI for all US providers is located her

An analysis of that file shows that there are 3619 hospital records. The number of cases for the hospitals ranges from a low of 1 to a high of 36,282 cases at Florida Hospital in Orlando, FL (Medicare ID 100007). That hospital has a Case Mix Index of 1.57. The mean number of cases across all the hospitals in the database is 3,098 with a standard deviation of 3,102. As far as the Case Mix Index, the average is 1.37 with a minimum of .58 and a max of 3.73 and a standard deviation of 0.31.

References

Medical manuals Medicare and Medicaid (United States) {{Health-stub

Resource Use Groups

Hospital CMI

See also

References