Max Rady College of Medicine

Concept: Interqual Criteria

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Concept Description

Last Updated: 1999-11-16

Level of Care Criteria

    InterQual Criteria are set of measurable, clinical indicators, as well as diagnostic and therapeutic services, that reflect a patient's need for hospitalization. Rather than being based on diagnosis, they consider the level of illness of the patient and the services required; thus they serve as the criteria for all acute hospital care, regardless of the location or size of the hospital.

    The criteria are grouped into 14 body systems, and there are 3 sets of criteria for each body system:

    • Intensity of Service
    • Severity of Illness
    • Discharge Screens

    Intensity Severity Discharge (ISD) Level of Care Criteria are used to determine the appropriateness of admission, continued services, and discharge, across the continuum of care. ISD uses objective, clinical indicators to determine the proper level of care, based on the patient's severity of illness and service requirements, and to suggest an appropriate care setting. Healthcare organizations around the world use ISD to stop overutilization, guard against underutilization, and manage financial risk via appropriate clinical means. ISD is intended to supplement and support the physician's own knowledge base.

    InterQual Clinical Decision Support Criteria help you ensure both the appropriateness of medical services and effective cost control. They are a proven demand management tool. Focused on clinical appropriateness, InterQual Criteria distill best medical practices into practical tools for guiding, monitoring and documenting point-of-care decisions.

Services and Training

    InterQual product training and implementation programs are available to all licensees. A wide range of delivery options accommodates virtually any need, including criteria software for client-server or stand-alone use, datasets for linkage to enterprise-wide systems, Alliance Partner software with integrated criteria, and hard copy books.

MORE INFORMATION

    Jacobs CM, Lamprey J (1993). Adult ISD Criteria and Review System and Pediatric ISD Criteria and Review System. North Hampton, NH: InterQual Inc.

Related terms 

References 

  • De Coster C, Peterson S, Kasian P. Alternatives to Acute Care . Winnipeg, MB: Manitoba Centre for Health and Evaluation, 1996. [Report] [Summary] (View)
  • De Coster C, Roos NP, Carriere KC, Peterson S. Inappropriate hospital use by patients receiving care for medical conditions: Targeting utilization review. Canadian Medical Association Journal 1997;157(7):889-896. [Abstract] (View)
  • Kasian P, De Coster C, Peterson S, Carriere KC. Assessing the extent to which hospitals are used for acute care purposes. Med Care 1999;37 (6 Suppl):66-151.(View)
  • Menec V, Roos NP, Nowicki D, MacWilliam L, Finlayson G, Black C. Seasonal Patterns of Winnipeg Hospital Use. Winnipeg, MB: Manitoba Center for Health Policy and Evaluation, 1999. [Report] [Summary] (View)

Keywords 

  • acute care
  • hospitalization
  • Interqual


Contact us

Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
Winnipeg, MB R3E 3P5 Canada

204-789-3819