The development of patient groupings for more effective management of health care

The concepts of groupings of patients and treatment episodes are fundamental to better analysis of data for health services management. This article discusses the need to separate out condition groupings (of patients) from resource groupings (of treatment episodes) and demonstrates the way in which the use of these two types of groups could assist in the development of health care planning/purchasing and in the monitoring of the efficiency/effectiveness/appropriateness of services. The use of these groupings for data analysis is the logical development of previous work on programme planning and budgeting, but this has been handicapped in the past by a lack of suitable data. The current developments in clinical information systems and clinical coding mean that we can look forward to richer and more complete data and this will require new grouping systems. Existing grouping systems may not be appropriate for dealing with more detailed information and work to develop new grouping concepts and groupers is required.