Can the Canadian Case Mix age group (0--17 yrs) be further refined to better represent the pediatric population?

Abstract

The Canadian Case Mix Groups or CMG(TM)* methodology groups acute care patients into clinically similar and resource homogenous groups, and further stratifies patients into three age categories (years): 0-17, 18-69 and 70+. Some healthcare practitioners believe that the 0-17 years CMG age group is too broad, and does not reflect age differences associated with hospital resources consumption. A methodological study was conducted, using linked Canadian inpatient activity and case cost data from 1997/98 to 2000/01, to examine whether or not the 0-17 years CMG age group can be further refined to better represent age differences in hospital resources consumption. The study utilized the Classification and Regression Tree (CART) algorithm and regression analyses to develop new age groups. Of the 123 CMG included in the study, CART recommended further age splits for at least 48% of the CMG. The study recommends that, subject to clinical validation, fixed age splits at 0.5 and 1.5 years of age could be applied across all CMG. *Registered Trade-mark of the Canadian Institute for Health Information.