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Current Uses of Large Data Sets to Assess the Quality of Providers: Construction of Risk-Adjusted Indexes of Hospital Performance

Published online by Cambridge University Press:  10 March 2009

Susan Desharnais
Affiliation:
University of North Carolina, Chapel Hill

Abstract

This article examines how large data sets can be used for evaluating the effects of health policy changes and for flagging providers with potential quality problems. An example is presented, illustrating how three risk-adjusted measures of hospital performance were developed using patient discharge abstracts. Advantages and disadvantage of this approach are discussed.

Type
Special Section: Measuring Health Care Effectiveness: Use of Large Data Bases for Technology and Quality Assessments
Copyright
Copyright © Cambridge University Press 1990

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References

REFERENCES

1Blumberg, M. S.Comments on HCFA hospital death rate statistical outliers. Health Services Research, 1987, 21, 715–39.Google ScholarPubMed
2Blumberg, M. S.Risk adjusting health care outcomes: A methodologic review. Medical Care Review, 1986, 43, 351–93.CrossRefGoogle ScholarPubMed
3DuBois, R. W., Brook, R. H., & Rogers, W. H.Adjusted hospital death rates: Potential screen for quality of care. American Journal of Public Health, 1987, 77, 1162–66.CrossRefGoogle Scholar
4DuBois, R. W. et al. , Hospital inpatient mortality: Is it a predictor of quality? New England Journal of Medicine, 1987, 317, 1674–80.CrossRefGoogle ScholarPubMed
5DesHarnais, S. I. et al. , The risk-adjusted mortality index: A new measure of hospital performance. Medical Care, 1988, 26, 1129–48.CrossRefGoogle ScholarPubMed
6DesHarnais, S. I., Chesney, J., & Fleming, S.Trends and regional variations in hospital utilization and quality during the first two years of the prospective payment system. Inquiry, 1988, 25, 374–82.Google ScholarPubMed
7Flood, A. B., Scott, W. R., & Ewy, W.Does practice make perfect? Part I: The relationship between hospital volume and outcomes for selected diagnostic categories. Medical Care, 1984, 22, 98114.Google Scholar
8Hsia, D. C. et al. , Accuracy of diagnostic coding for Medicare patients under the prospective- payment system. New England Journal of Medicine, 1988, 318, 352–55.CrossRefGoogle ScholarPubMed
9Luft, H. S.The relation between surgical volume and mortality: An exploration of causal factors and alternative models. Medical Care, 1980, 18, 940–59.CrossRefGoogle ScholarPubMed
10Wagner, D. P., Knaus, W. A. & Draper, E. A.The case for adjusting hospital death rates for severity of illness. Health Affairs, 1986, 5, 149.CrossRefGoogle ScholarPubMed