A method for estimating relative complexity of ambulatory care.

Annals of Family Medicine
David A KaterndahlCarlos Roberto Jaén

Abstract

We wanted to demonstrate a method for calculating the relative complexity of ambulatory clinical encounters. Measures of complexity should reflect the complexity of the typical encounter and across encounters. If inputs represent the information transferred from the patient to the physician, then inputs include history, physical examination, testing, diagnoses, and patient demographics. Outputs include medications prescribed and other therapies used, including education and counseling, procedures performed, and disposition. The complexity of each input/output is defined as the mean input/output quantity per clinical encounter weighted by its inter-encounter diversity (range of possibilities used) and variability (visit-to-visit change). In complex systems, as the information in the input increases linearly, the complexity of the system increases exponentially. To assess the impact of the complexity of the encounter on the physician, we adjusted the estimated complexity by the duration-of-visit. Using the 2000 NAMCS database, we calculated input and output complexities for 3 specialties. Construct validity was affirmed by comparing the relative rankings of complexity against relative rankings using other complexity-related measu...Continue Reading

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Citations

Jul 21, 2010·Annals of Family Medicine·Kurt C Stange
Feb 18, 2012·BMC Family Practice·Alan KatzJordan Sloshower
Dec 15, 2015·Journal of Evaluation in Clinical Practice·David KaterndahlCarlos R Jaen
Dec 2, 2015·BMC Medical Informatics and Decision Making·Roosan IslamMatthew H Samore
Sep 18, 2010·Journal of Evaluation in Clinical Practice·Carmel M Martin
Mar 21, 2013·Journal of Evaluation in Clinical Practice·David Katerndahl, Michael Parchman
Jul 17, 2015·Healthcare : the Journal of Delivery Science and Innovation·David KaterndahlCarlos Roberto Jaén
Dec 19, 2013·The Journal of Continuing Education in the Health Professions·Lise M BjerreDouglas Archibald
Nov 21, 2014·The European Journal of General Practice·Richard G Roberts, John Wynn-Jones
Jan 23, 2013·The European Journal of General Practice·Richard G Roberts
Nov 8, 2016·Journal of Biomedical Informatics·Don RoosanGuilherme Del Fiol
Mar 29, 2018·Journal of Evaluation in Clinical Practice·Carmel M Martin
Apr 15, 2014·Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine·Yasushi Miyata
Apr 4, 2017·Journal of Evaluation in Clinical Practice·Waltraud FinkMartin Konitzer
Mar 12, 2020·Journal of General Internal Medicine·John D GoodsonZirui Song
Jul 1, 2020·Journal of Evaluation in Clinical Practice·Richard A YoungCarmel M Martin
Jun 8, 2018·Journal of Evaluation in Clinical Practice·Michael A KolberJohn B Sory
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Jan 19, 2021·Journal of Patient Experience·Jaya AysolaRachel M Werner
Apr 8, 2021·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Chris SalisburyFd Richard Hobbs

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