Thompson, John Devereaux

Familiarly known as Tommy, John Devereaux Thompson was a nurse, health administration educator, and health services researcher. Thompson along with Robert B. Fetter developed Diagnosis Related Groups (DRGs) as a tool to standardize hospital cases for studies of quality and cost, subsequently changing the way the nation's hospitals were reimbursed when Medicare adopted DRGs for its prospective payment system (PPS). Thompson's passions for studying the history of hospital operations as well as nursing resulted in a creative and respected book that focused on the social and architectural history of hospitals.

Born in Franklin, Pennsylvania, Thompson was raised in Canton, Ohio. Thompson's stepmother, a nurse, encouraged him to also become a nurse. Following her advice, he completed his nurse training program in 1939. With World War II imminent, he enlisted in the U.S. Navy and served as a pharmacist's mate, eventually achieving the rank of warrant officer. After the war, he enrolled in the City College of New York in 1948, working nights as a nurse riding ambulances and doing psychiatric nursing. Thompson received his bachelor's degree with distinction in business. Subsequently, he enrolled in the new hospital administration program at Yale University and undertook the required administrative residency training at Montefiore Hospital in New York City. Thompson completed this praxis experience in 1950 and remained at Montefiore Hospital for 6 years, becoming one of the hospital's assistant directors. Albert W. Snoke, then director of the hospital administration program at Yale and senior administrator at the then Grace-New Haven Hospital, had received a federal Hill-Burton grant to study hospital function and design, and he was successful in recruiting Thompson back to Yale in 1956.

Thompson's directorship of the hospital administration program at Yale University was novel in its emphasis on public health, yielding students who recognized that their actions as health services managers must be related to improving the health status of communities. He was beloved as a teacher and mentor.

Much of Thompson's research was based on his underlying philosophy that clinical and administrative data must be brought together to identify and solve both operational and financial problems. Thompson was instrumental in creating the Connecticut Hospital Information Management Exchange (CHIME), one of the first of 34 statewide databases built from hospital billing systems that form the foundation of large data sets, which are often used for health services research.

Thompson studied operations research with Russell A. Nelson and Charles D. Flagle at the Johns Hopkins University School of Engineering. This interest in data and their use for management decision making as well as for policy formulation and analysis led Thompson to develop a research and teaching relationship with Robert B. Fetter, then in Yale University's Department of Administrative Sciences. With others, they were important in developing the Center for Health Services Research in Yale University's Institute for Social and Policy Studies; the Center was among the first in the country.

Thompson's published articles include topics such as hospital operations, including nursing services and nursing intensity, hospital function and design, application of operations research to hospital studies, costs of care, economics of care, education for health services administration, emergency medical services, chronic hemodialysis, the role of schools of public health, hospital architecture, case-mix cost accounting, regulation, DRGs and hospital prospective-based payment, quality appraisal, and cost funding.

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