Relating patient characteristics at the time of admission to outcomes of hospitalization

Abstract

In clinical practice, physicians informally address patient characteristics such as illness severity, comorbidity, functional status and stability when considering prognosis and diagnostic or therapeutic interventions. These same attributes, more formally measured, have been used as measures of casemix in clinical research to classify patients into similar risk strata. To determine whether physician estimates of illness severity, function status and stability were predictive of morbidity, mortality, length of stay and average daily ancillary charges, a cohort of 604 patients was studied. The predictive ability of the patient characteristics were found to be outcome specific. Illness severity was a significant predictor of in-hospital morbidity and mortality, length of stay and charges (p less than 0.001). Functional status was predictive of in-hospital morbidity and mortality, 1 year mortality, length of stay and charges (p less than 0.01). Physician estimates of stability were predictive only of morbidity (p less than 0.01) and comorbidity was only a preditor of 1 year mortality (p less than 0.001). Stratifying patients on the basis of specific clinical characteristics determined at the time of admission will be useful in studies of patient outcomes and resource utilization.