The diagnosis-specific makeup of a health program’s workload. Case-mix directly influences the length of stays in, and intensity, cost and scope of the services provided by a hospital or other health program.
The mix of cases, defined by age, sex, diagnoses, treatments, severity of illness, and so on, handled by a practitioner or hospital. Case mix is defined by: (1) grouping patients (classification) according to these factors; and then (2) determining the proportion of the total falling into each group. At present, the most widely used classification for this purpose is the Diagnosis Related Group (DRG) system. Sometimes the term “case mix” is used, inaccurately, to mean the grouping system itself (DRG, for example).
The unique characteristics of any patient population, e.g., its history of behavioral or medical illnesses, or its socioeconomic status. The unique characteristics of different groups of patients alter many variables relating to the care they receive. A group of healthy twenty-year-old men serving in the military overseas has different needs than a rural community primarily composed of retired people. Differences in case mix affect health care costs, the need for specialist care, nursing home care, hospice care, prenatal care, and specific medications.