Stratifying clinical complexity of dermatology outpatient visits: Validation of a pilot instrument

The United States population is aging and increasing in comorbidities, and patient care is accordingly growing increasingly complex. Complexity impacts patterns of resource consumption, adverse event and medical error rates, health-related quality of life, physician burnout, and more. Tools capturin...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2023-05, Vol.88 (5), p.e251-e258
Main Authors: Murthy, Rajini K., Kahn, Benjamin J., Zhang, Chao, Chen, Suephy C.
Format: Article
Language:English
Subjects:
clinical complexity
CMS
complexity
Cross-Sectional Studies
DataDerm
Dermatology
health services
Humans
informatics
level of risk
medical decision making
Merit-based Incentive Payment System
outpatient
Outpatients
performance measures
pilot instrument
Pilots
Quality of Life
Reproducibility of Results
resource allocation
Retrospective Studies
risk adjustment
United States
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Summary:The United States population is aging and increasing in comorbidities, and patient care is accordingly growing increasingly complex. Complexity impacts patterns of resource consumption, adverse event and medical error rates, health-related quality of life, physician burnout, and more. Tools capturing complexity can be of benefit in the modern value-based reimbursement landscape and have been well studied in specialties other than dermatology. In this report, we describe the validation of a tool specific to outpatient dermatologic care that captures the complexity of clinical visit medical decision making. We performed a cross-sectional retrospective study to determine the inter-rater reliability and face validity of the tool. By objectively grading a clinical encounter based on clinical complexity, there is increased awareness of opportunities to improve clinical care, and the allocation of health care costs and resources within the dermatologic community can be better assessed.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2019.02.025