Severity of Illness Index and the Adverse Patient Occurrence Index

Seven hundred fifty-two randomly selected charts from seven teaching hospitals were rated by pairs of medical record analysts. The Severity of Illness Index was unreliable with an interrater-agreement rate of 73% (kappa statistic = 0.41), and demonstrated a significant (P less than 0.0001) association with the Adverse Patient Occurrence (APO) Index. This suggests that the Severity of Illness Index is not differentiating severity of illness from quality of care. The fair to poor field reliability stems from underlying instrument subjectivity, lack of clear referent groups, and time pressure. The APO Index was also found to be unreliable (r = 0.33 and range = -0.05-0.58). Greater attention should be directed to improving objective discharge abstract, billing, and laboratory data for measuring patient severity and adverse patient occurrences

Index (typography) · Severity of illness · Computer Science · Internal Medicine · Medical Malpractice and Liability Issues · Medicine · Meta-analysis and systematic reviews · Reliability and Agreement in Measurement

• Longer Hospitalization at Veterans Administration Hospitals Than Private Hospitals

  James L Rogers, Joe Feingla et al.•Medical Care•1989

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• Sentinel health events as indicators of unmet needs

  Open Access•Willine Carr, Natan Szapiro et al.•Social Science & Medicine•1989

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• A Coefficient of Agreement for Nominal Scales

  Open Access•Jacob Cohen•Educational and Psychological…•1960

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• Measuring Severity of Illness

  Susan D Horn•American Journal of Public Health•1983

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• Issues in the Use of Kappa to Estimate Reliability

  Karen L Soeken, Patricia A Prescott•Medical Care•1986

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• Comparing Classification Methods

  Susan D Horn, Dale N Schumacher•Medical Care•1982

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• Measuring Severity of Illness

  Susan D Horn, Phoebe D Sharkey et al.•Medical Care•1983

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• Measuring Severity of Illness

  Susan D Horn, Bette Chachich et al.•Medical Care•1983

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