Using medicare claims data to assess provider quality for CABG surgery: Does it work well enough?

Health Services Research

Volumn 31, Issue 6, 1997, Pages 659-678

  Hannan, Edward L ^a   Racz, Michael J ^a   Jollis, James G ^a   Peterson, Eric D ^a  

^a NONE

Author keywords

Administrative data; CABG surgery; Medicare data; quality assessment

Indexed keywords

ARTICLE; CORONARY ARTERY BYPASS GRAFT; DATA ANALYSIS; HEALTH CARE QUALITY; HOSPITAL CARE; MEDICARE; PREDICTION; RISK ASSESSMENT; SURGICAL MORTALITY; SURGICAL RISK;

BIAS (EPIDEMIOLOGY); CARDIOLOGY SERVICE, HOSPITAL; CORONARY ARTERY BYPASS; DATABASES, FACTUAL; DISCRIMINANT ANALYSIS; FEMALE; HOSPITAL MORTALITY; HUMANS; INSURANCE CLAIM REPORTING; LOGISTIC MODELS; MALE; MEDICARE PART A; NEW YORK; OUTCOME ASSESSMENT (HEALTH CARE); PREDICTIVE VALUE OF TESTS; REPRODUCIBILITY OF RESULTS; RISK FACTORS; UNITED STATES; UNITED STATES CENTERS FOR MEDICARE AND MEDICAID SERVICES;

EID: 0031037746     PISSN: 00179124     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (20)

1. Breslow, N. E., and N. E. Day. 1991. Statistical Methods in Cancer Research. New York: Oxford University Press.
2. Dubois, R. W., R. H. Brook, and W. H. Rogers. 1987. "Adjusted Hospital Death Rates: A Potential Screen for Quality of Care." American Journal of Public Health 77 (9): 1162-66.
3. Fisher, E. S., F. S. Whaley, W. M. Krushat, D. J. Malenka, C. Fleming, J. A. Baron, and D. C. Hsia. 1992. "The Accuracy of Medicare's Hospital Claims Data: Progress Has Been Made, but Problems Remain." American Journal of Public Health 82 (2): 243-48.
4. Hannan, E. L., H. R. Bernard, J. F. O'Donnell, and H. Kilburn. 1989. "A Methodology for Targeting Hospital Cases for Quality of Care Record Reviews." American Journal of Public Health 79 (4): 430-36.
5. Hannan, E. L., H. Kilburn, Jr., M. L. Lindsey, and R. Lewis. 1992. "Chinical versus Administrative Data Bases for CABG Surgery: Does It Matter?" Medical Care 30 (10): 892-907.
6. Hannan, E. L., H. Kilburn, Jr., M. Racz, E. Shields, and M. R. Chassin. 1994_ "Improving the Outcomes of Coronary Artery Bypass Surgery in New York State." Journal of the American Medical Association 271 (10): 761-66.
7. Health Care Financing Administration. 1991. "Medicare Hospital Mortality Information, 1987-1988-1989." HCFA Publication No. 00744. Washington, DC: Government Printing Office.
8. Hsia, D. C., W. M. Krushat, A. B. Fagan, J. A. Tebbutt, and R. P. Kusserow. 1988. "Accuracy of Diagnostic Coding for Medicare Patients under the Prospective Payment System." The New England Journal of Medicine 318 (6): 352-55.
9. Iezzoni, L. I. 1990. "Using Administrative Diagnostic Data to Assess the Quality of Diagnostic Care: The Pitfalls and Potential of ICD-9-CM." International Journal of Technology Assessment in Health Care 6 (2): 272-81.
10. Iezzoni, L. I., S. M. Foley, J. Daley, J. Hughes, E. S. Fisher, and T. Heeren. 1992. "Comorbidities, Complications, and Coding Bias." Journal of the American Medical Association 267 (16): 2197-203.
11. Iezzoni, L. I., J. Daley, T. Heeren, S. M. Foley, J. S. Hughes, E. S. Fisher, C. Duncan, and G. A. Coffman. 1994. "Using Administrative Data to Screen Hospitals tor High Complication Rates." Inquiry 30, no. 1 (spring): 40-55.
12. Tollis, J. G., M. Ancukiewicz, E. DeLong, D. B. Pryor, L. H. Muhlbaier, and D. B. Mark. 1993. "Discordance of Databases Designed for Claims Payment versus Clinical Information Systems: Implications for Outcomes Research." Annals of Internal Medicine 119 (6): 844-50.
13. Krakauer, H., R. C. Bailey, K. J. Skellan, J. D. Stewart, A. J. Hartz E. M. Kuhn, and A. A. Rimm. 1992. "Evaluation of the HCFA Model for the Analysis of Mortality Following Hospitalization." Health Services Research 27 (3): 317-35.
14. Landis, J. B., and G. G. Koch. 1977. "The Measurement of Observer Agreement for Categorical Data." Biometrics 33 (1): 159-74.
15. O'Connor G. T., S. K. Plume, E. M. Olmstead, L. H. Coffin J. R. Morton, C. T. Maloney, E. R. Nowicki, D. G. Levy, J. F. Tryzelaar, and F. Hernandez. 1992. "Multivariate Prediction of In-hospital Mortality Associated with Coronary Artery Bypass Graft Surgery." Circulation 85 (6): 2110-118.
16. The Pennsylvania Health Care Cost Containment Council. 1994. Coronary Artery Bypass Graft Surgery, Technical Report, Vol. II: 1991. The Pennsylvania HCCCC, Harrisburg, February.
17. Pryor, D. B., R. M. Califf, F. E. Harrell, M. A. Hlatky, K. L. Lee, D. B. Mark, and R. A. Rosati. 1985. "Clinical Data Bases: Accomplishments and Unrealized Potential." Medical Care 23 (5): 623-47.
18. Romano, P. S., L. L. Roos, J. G. Jollis, K. Doliszny, and the Ischemic Heart Disease Patient Outcomes Research Team. 1994. "A Comparison of Administrative versus Clinical Data: Coronary Artery Bypass Surgery as an Example." Journal of Clinical Epidemiology 47 (3): 249-60.
19. Roos, L. L., S. M. Cageorge, E. Austen, and K. N. Lohr. 1985. "Using Computers to Identify Complications after Surgery." American Journal of Public Health 75 (11): 1288-95.
20. Tu, J. V., S. B. Jaglal, C. D. Naylor, and the Steering Committee of the Provincial Adult Cardiac Care Network of Ontario. 1995. "Multicenter Validation of a Risk Index for Mortality, Intensive Care Unit Stay, and Overall Hospital Length of Stay after Cardiac Surgery." Circulation 91 (3): 677-84.