Weights/Case-mix Overview

The HSCRC uses equivalent case-mix adjusted discharges (ECMADs) for quantifying inpatient and outpatient hospital volume into a single measure. A hospital’s ECMAD includes; case mix adjusted discharges, and equivalent outpatient case-mix adjusted visits. Inpatient weights reflecting relative complexity and resource demands, and a single inpatient discharge with up to 30 diagnosis and procedure codes can be attributed to a single diagnosis related group (DRG). Outpatient weights a single outpatient visit can contain up to 45 Current Procedural Terminology (CPT) codes, and therefore Enhanced Ambulatory procedure Groups (EAPGs) and requires a more complex weighting methodology.