Case-mix
A case mix describes the diversity and complexity of patients within a particular healthcare institution, department or group. It helps to understand how intensive or complex the care provided by a healthcare provider is.
A case mix takes into account various factors relating to patients, such as:
• Clinical situation (e.g. pneumonia vs. cancer)
• Severity of the health condition
• Comorbidities (other diseases or conditions)
• Age
• Self-reliance/care needs
• Socio-economic factors
It is used for:
1. Financing and reimbursement
• Hospitals or residential care centres sometimes receive more resources or reimbursement for a more severe case mix.
2. Quality comparison
• When comparing healthcare institutions, the case mix is taken into account to ensure a fair comparison. You cannot simply compare a hospital with many complex patients with a hospital that mainly treats simple cases.
3. Staff planning
• A more severe case mix often requires more healthcare providers or more specialised care.