Concept: Interqual Criteria

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.