Disease staging: implications for hospital reimbursement and management

Abstract

The current patient classification schemes used in case-mix reimbursement are not fully sensitive to variations in resource consumption that are associated with differential disease severity. Disease staging is a clinically based measure of severity that uses objective medical criteria to assess the stage of disease progression. Its availability in automated form increases its ease of implementation in hospital reimbursement and management. Results of recent studies demonstrate that staging is a useful case-mix reimbursement and management tool that explains significant variation in cost per discharge within current diagnosis-related groups.