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© 1997 Oxford University Press

Articles

RUG-III and Resource Allocation: Comparing the Relationship of Direct Care Time with Patient Characteristics in Five Countries

G. Iain Carpenter, N. Ikegami1, Gunnar Ljunggren2, E. Carrillo3 and E. Fries4

Centre for Health Services Studies, George Allen Wing, University of Kent Canterbury, CT2 7NF, UK
1 Department of Health Policy and Management, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan
2 RAI Unit, Sabbatsberg sjukhus, Box 6401, S-1 13 82 Stockholm, Sweden
3 Bossard Salud y Gestion Via Augusta 4, 08006 Barcelona, Spain
4 Institute of Gerontology, University of Michigan 300 North Ingalls, Ann Arbor Ml 48109-2007, USA

Address correspondence to G. I. Carpenter Fax: (+44) 1227 823878. Email: g.i.carpenter{at}ukc.ac.uk

Background: Resource use by different types of patients is of increasing interest to health care services all over the world. Case-mix systems that group together individuals with similar patterns of resource use have been developed to address these questions. Resource Utilization Groups version III (RUG-III) was developed in the USA to address the issue in the care of elderly people and has been validated in a number of countries.

Method: This paper synthesizes the results of RUG-III validation studies performed in the USA, Japan, Spain, Sweden and England and Wales, showing the consistency of the system in spite of different skill-mix and total time spent with patients. Data from the validation studies of five countries were compared. Percentage of time given by trained nurses and mean nursing time per patient was compared overall and between selected RUG-III groups.

Results: Mean time per patient ranged from 84.4 min per day in Japan, to 155.6 min in England and Wales. Trained nurse time ranged from 7.5% of total time in the USA to 53.2% of total time in England and Wales. The inter-group relationship was very similar in all countries. The RUG-III system appears robust in a wide variety of settings and countries. Future research should address the relationship between skill-mix and total time spent with patients with respect to outcome and quality of care.

Keywords: case-mix, long-term care, nurse resource use


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 Scand J Public HealthHome page
M. A. Bjorkgren, U. Hakkinen, U. H. Finne-Soveri, and B. E. Fries
Validity and reliability of Resource Utilization Groups (RUG-III) in Finnish long-term care facilities
Scand J Public Health, July 1, 1999; 27(3): 228 - 234.
[Abstract] [PDF]


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