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Care Complexity in the General Hospital

Results From a European Study

Received March 20, 2000; revised October 10, 2000; accepted October 29, 2000. From Psychiatric C-L service, Vrije Universiteit Hospital, Amsterdam; Department of Internal Medicine, University Hospital, Groningen, The Netherlands Hospital, Amsterdam; Department of Psychotherapy and Psychosomatic Medicine, Albert Ludwigs University, Freiburg, Germany; Psychosomatic and C-L Psychiatry Service, Hospital Clinico Universitario, Zaragoza, Spain; Department of Psychiatry, Northwestern University Medical School, Chicago, Illinois; Department of Psychiatry, University of Muenster, Muenster, Germany; Department of Medical Informatics, Institute of Cardiology, Budapest, Hungary; Department of Psychiatry, Hospital Fernando Fonseca, Amadora, Portugal; the Research Unit for Functional Disorders, Psychosmatics and C-L Psychiatry, Aarhus University Hospital, Aarhus, Denmark; Department of Psychiatry, University Hospital, Modena, Italy. Address correspondence to Dr. de Jonge, Psychiatrische Consultatieve Dienst, Academisch Ziekenhuis der Vrije Universiteit, Postbus 7057, 1007 MB Amsterdam. E-mail: p.dejonge{at}azvu.nl

There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between complexity indicators, highlighting differences between length of stay (LOS), objective complexity (such as medications or consultations), complexity ratings by the nurse, and complexity ratings by the doctor. Their findings illustrate limitations in the use of LOS as a sole indicator for care complexity. The authors show how objective and subjective complexity indicators can be used for early and valid detection of patients needing interdisciplinary care.

Key Words: Treatment • Length of Stay

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