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Joseph S. Gonnella, MD

JAMA. 1986;255(7):941-942.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Accommodating different and divergent interests is not an easy task. Utilizing classification systems that fail to meet basic medical concepts, in terms of which disease and illness are understood, makes this task even more difficult. This can be seen in the article by Drs Iezzoni and Moskowitz¹ in this issue of THE JOURNAL.

The goal of any classification system is to ensure that homogeneity is inherent in each category classified. An optimal classification system allows the prognosis and resource needs to be compared for individuals with "similar illnesses." The problem is the definition of "similar illness." Even though there may be biological similarities, there will be social differences that will affect patient care. Patient expectations and demands will also vary and will influence the effectiveness of the care given. Thus, case mix classification is an exercise in how best to pretend that what is in fact heterogeneous is homogeneous. The . . . [Full Text PDF of this Article]

Author Affiliations
Jefferson Medical College Thomas Jefferson University Philadelphia

Footnotes
Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.

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