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INTERMED—A Clinical Instrument for Biopsychosocial Assessment

Received March 3, 2000; revised June 30, 2000; accepted October 25, 2000. From Psychiatrische Consultatieve Dienst, Ziekenhuis der Vrije Universiteit, Amsterdam, The Netherlands; Service de Psychiatrie de Liaison, University Hospital, Lausanne, Switzerland; and Algemene Inwendige Geneeskunde, Academisch Ziekenhuis Groningen, Groningen, The Netherlands. Address correspondence and reprint requests to Dr. de Jonge, Psychiatrische Consultatieve Dienst, Ziekenhuis der Vrije Universiteit, De Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.

Using the INTERMED, a system for classifying case complexity, the authors evaluated patients admitted to a general internal medicine ward on length of stay (LOS), number of medicines prescribed during the hospital stay, and whether they had received specialist medical consults. Using the patients' INTERMED scores, the authors divided the patients into three clusters of patients: standard (n=41), chronic (n=26), and complex (n=18). A comparison of the three clusters indicated that patients who had scored within the complex cluster were at risk of requiring complex care and an increased LOS. The findings suggest that the INTERMED detects complex patients at admission and may, therefore, be used for early integral case management.

Key Words: Case Complexity • Health Care Utilization

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