The Public Release of Hospital and Physician Mortality Data in Pennsylvania: A Case Study

Medical Care

Volumn 35, Issue 3, 1997, Pages 272-286

  Localio, A Russell ^a   Hamory, Bruce H ^b   Fisher, Alicia Cocks ^a   Tenhave, Thomas R ^a  

^a PENN STATE COLLEGE OF MEDICINE   (United States)

^b PENNSYLVANIA STATE UNIVERSITY   (United States)

Author keywords

Coronary artery bypass; Data interpretation; Hospital mortality; Severity of illness index; Small area analysis; Statistical methods

Indexed keywords

ARTICLE; CLASSIFICATION; CLINICAL PRACTICE; CLUSTER ANALYSIS; CORONARY ARTERY BYPASS GRAFT; CORONARY ARTERY DISEASE; CORONARY CARE UNIT; DIAGNOSIS RELATED GROUP; EPIDEMIOLOGY; FACTUAL DATABASE; HOSPITALIZATION; HUMAN; INFORMATION SERVICE; MORTALITY; RESIDENTIAL CARE; STANDARD; STATISTICAL MODEL; STATISTICS; UNITED STATES;

CARDIOLOGY SERVICE, HOSPITAL; CATCHMENT AREA (HEALTH); CORONARY ARTERY BYPASS; CORONARY DISEASE; DATABASES, FACTUAL; HOSPITAL MORTALITY; HUMANS; INFORMATION SERVICES; MODELS, STATISTICAL; OUTLIERS, DRG; PENNSYLVANIA; PHYSICIAN'S PRACTICE PATTERNS; SELECTION BIAS; SEVERITY OF ILLNESS INDEX; SMALL-AREA ANALYSIS;

EID: 0031093091     PISSN: 00257079     EISSN: None     Source Type: Journal    
DOI: 10.1097/00005650-199703000-00007     Document Type: Article

References (86)

1. Brinkley J. You bet your life. Do you know the odds? The furor over data on doctors. The New York Times 1994 May 29;143:4.
2. Health Care Cost Containment Act, Act No. 1986-89.
3. Pennsylvania Health Care Cost Containment Council. A consumer guide to coronary artery bypass graft surgery. Harrisburg PA: PH4C; 1992.
4. Pennsylvania Health Care Cost Containment Council. A consumer's guide to coronary artery bypass surgery. Vol II. Harrisburg, PA: PH4C, 1994.
5. Pennsylvania Health Care Cost Containment Council. A consumer's guide to coronary artery bypass surgery. Vol III. Harrisburg, PA: PH4C, 1994.
6. Priest D. Pennsylvania rates hospitals, surgeons on heart bypass patient deaths. Washington Post 1992 Nov 20:A3.
7. Clinton WJ. Address of the President to the joint session of Congress. Washington, DC: Office of the Press Secretary, The White House, September 22, 1993.
8. Clinton HR. Testimony of First Lady Hillary Rodham Clinton. Health Care Reform. House of Representatives, Committee on Energy and Commerce. 103rd Congress, 1st Session. September 28, 1993. Washington, DC: US Government Printing Office; 1994.
9. Park RE, Brook RH, Kosecoff J, et al. Explaining variations in hospital death rates: Randomness, severity of illness, and quality of care. JAMA 1990;264:484.
10. Greenfield S, Aronow HU, Elashoff RM, Watanabe D. Flaws in mortality data: The hazards of ignoring comorbid disease. JAMA 1988;260:2253.
11. Burns R, Nichols LO, Graney MJ, Applegate WB. Mortality in a public and a private hospital compared: The severity of antecedent disorders in Medicare patients. Am J Public Health 1993;83:966.
12. Iezzoni LI, Shwartz M, Restuccia J. The role of severity information in health policy debates: A survey of state and regional concerns. Inquiry 1991;28:117.
13. Hannan EL, Kilburn H, Lindsey ML, Lewis R. Clinical versus administrative data bases for CABG surgery. Does it matter? Med Care 1992;30:892.
14. Tolchin M. US plans to rate doctors treating Medicare patients. The New York Times 1988 Jun 12;137:1.
15. Vladeck calls temporary halt to annual Medicare death studies. Medical Utilization Review 1993;June 10;21(11):1.
16. Topol EJ, Califf RM. Scorecard cardiovascular medicine. Its impact and future directions. Ann Intern Med 1994;120:65.
17. Selker HP Systems for comparing actual and predicted mortality rates: Characteristics to promote cooperation in improving hospital care. Ann Intern Med 1993;118:820.
18. Barnes BA, O'Brien E, Comstock C, D'Arpa DG, Donahue CL. Report on variation in rates of utilization of surgical services in the Commonwealth of Massachusetts. JAMA 1985;254:371.
19. Chassin MR, Brook RH, Park RE, et al. Variations in the use of medical and surgical services by the Medicare population. N Engl J Med 1986;314:285.
20. Showstack JA, Rosenfeld KE, Garnick DW, Luft HS, Schaffarzick RW, Fowles J. Association of volume with outcome of coronary artery bypass graft surgery. JAMA 1987;257:785.
21. Chassin MR. Explaining geographic variations: The enthusiasm hypothesis. Med Care 1993;5:YS37.
22. Roos NR Black CD, Roos LL, Tate RB, Carriere KC. A population-based approach to monitoring adverse outcomes of medical care. Med Care 1995;33:127.
23. Miller MG, Miller LS, Fireman B, Black SB. Variation in practice for discretionary admissions. JAMA 1994;271:1493.
24. Wilson R. State rates heart surgeons by mortality. The Wall Street Journal 1992 Nov 20;220(102):B1.
25. Iezzoni LI, Moskowitz MA. A clinical assessment of MedisGroups. JAMA 1988;260:3159.
26. The Pennsylvania Health Care Cost Containment Council. Coronary Artery Bypass Surgery. Vol II. Harrisburg, PA: PH4C, 1994. Technical Report.
27. Brown BW, Chan A, Gutierrez D, Herson J, Lovato J, Polsley J. STPLAN. Version 3.0. Houston, TX: University of Texas: 1990.
28. Romano PS, Roos LL, Jollis JG. Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: Differing perspectives. J Clin Epidemiol 1993;46:1075.
29. Deyo RA. Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992;45:613.
30. Charlson ME, Pompei P Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chron Dis 1987;40:373.
31. Luft HS, Brown BW Jr. Calculating the probability of rare events: Why settle for an approximation? Health Serv Res 1993;28:419.
32. Greenland S, Robins JM. Empirical-Bayes adjustments for multiple comparisons are sometimes useful. Epidemiology 1991;2:244.
33. Thomas DC, Siemiatycki J, Dewar R, Robins J, Goldberg M, Armstrong BG. The problem of multiple inference in studies designed to generate hypotheses. Am J Epidemiol 1985;122:1080.
34. Caper P. Geographic variations in the use of health care services. JAMA 1988;259:1947. Letter.
35. Kahn HA, Sempos CT. Statistical methods in epidemiology. New York: Oxford; 1989:95.
36. Langa KM, Sussman EJ. The effect of cost-containment policies on rates of coronary revascularization in California. N Engl J Med 1993;329:1784.
37. Clayton D, Kaldor J. Empirical Bayes estimates of age-standardized relative risks for use in disease mapping. Biometrics 1987;43:671.
38. Cain KC, Diehr P. Testing the null hypothesis in small area analysis. Health Serv Res 1992;27:267.
39. Flanders WD, Shipp CC, FitzGerald DM, Lin LS. Analysis of variations in mortality rates with small numbers. Health Services Res 1994;29:461.
40. McCullagh P, Neider JA. Generalized linear models. 2nd ed. London: Chapman and Hall; 1989:198.
41. Thomas N, Longford NT, Rolph JE. Empirical Bayes methods for estimating hospital-specific mortality rates. Stat Med 1994;13:889.
42. McNeil BJ, Pedersen SH, Gatsonis C. Current issues in profiling quality of care. Inquiry 1992;29:298.
43. Longford NT. Random coefficient models. New York: Oxford, 1993.
44. Gatsonis C, Normad SL, Liu C, Morris C. Geographic variation of procedure utilization: A hierarchical model approach. Med Care 1993;31:YS54.
45. Robinson GK. That BLUP is a good thing: The estimation of random effects. Stat Science 1991;6:15.
46. Zeger SL, Karim MR. Generalized linear models with random effects: A Gibbs sampling approach. J Am Stat Assoc 1991;86:79.
47. Wolfinger R, O'Connell M. Generalized linear mixed models: A pseudo-likelihood approach. J Stat Computation and Simulation 1993;48:233.
48. Galewitz P. Medical community calls report "flawed." The Patriot (Harrisburg PA) 1992 Nov 20;151:B1.
49. Jencks SF, Williams DK, Kay TL. Assessing hospital-associated deaths from discharge data: The role of length of stay and comorbidities. JAMA 1988;260:2240.
50. Feinstein AR. Para-analysis, faute de mieux, and the perils of riding on a data barge. J Clin Epidemiol 1989;10:929.
51. Guadagnoli E, McNeil BJ. Outcomes research: Hope for the future or the latest rage. Inquiry 1994;31:14.
52. Schneidman D. The public dissemination of physician-specific data: Who has the right to know? Bulletin of the American College of Surgeons 1993 August; 78(8):4.
53. Green J, Wintfeld N. Report cards on cardiac surgeons. Assessing New York State's approach. N Engl J Med 1995;332:1229.
54. Davies HTO, Crombie IK. Assessing the quality of care: Measuring well-supported processes may be more enlightening than monitoring outcomes. BMJ 1995;311:766.
55. Califf RM, Jollis JG, Peterson ED. Operator-specific outcomes: A call for professional responsibility. Circulation 1996;93:403.
56. Kolata G. New frontier in research: Mining patient records. The New York Times 1994 Aug 9;143:A21.
57. Meier B. Hurdles await efforts to rate doctors and medical centers. The New York Times 1994. Mar 31;143:A1.
58. Moore FD. Surgical streams in the flow of health care financing. Ann Surg 1985;201:132.
59. Snedecor GW, Cochron WG. Statistical methods. 7th ed. Ames, IA: Iowa State University Press; 1980;117.
60. Moses LE. Statistics in practice: The series of consecutive cases as a device for assessing outcomes of intervention. N Engl J Med 1984;311:705.
61. Localio AR, Hamory BH, Sharp TJ, Weaver SL, Ten-Have TR, Landis JR. Comparing hospital mortality in adult patients with pneumonia. Ann Intern Med 1995;122:125.
62. Smith DW. Evaluating risk adjustment by partitioning variation in hospital mortality rates. Stat Med 1994;10:1001.
63. Inglefinger JA, Mosteller F, Thibodcau LA, Ware JH. Biostatistics in clinical medicine. New York: McMillan Publishing; 1983:258.
64. Copeland GP, Sagar P, Brennan J, et al. Risk-adjusted analysis of surgeon performance: A 1-year study. Br J Surg 1995;82:408.
65. Orchard C. Comparing healthcare outcomes. BMJ 1994;308:1493.
66. Iezzoni LI. Using administrative diagnostic data to assess the quality of hospital care. Internat J Technol Assess Health Care 1990;6:272.
67. Fisher ES, Whaley FS, Krushat WM, et al. The accuracy of Medicare's hospital claims data: Progress has been made but problems remain. Am J Public Health 1992;82:243.
68. Jencks SF. Accuracy in recorded diagnoses. JAMA 1992;267:2238.
69. Iezzoni LI, Foley SM, Daley J, Hughes J, Fisher ES, Heeren T. Comorbidities, complications, and coding bias. Does the number of diagnosis codes matter in predicting in-hospital mortality? JAMA 1992;267:2197.
70. Romano PS, Mark DH. Bias in the coding of hospital discharge data and its implications for quality assessment. Med Care 1994;32:81.
71. Roos LL, Sharp SM, Cohen MM, Wajda A. Risk adjustment in claims-based research: The search for efficient approaches. J Clin Epidemiol 1989;1193.
72. Brook RH. Health care reform is on the way: Do we want to compete on quality? Ann Intern Med 1994;120:84. Editorial.
73. Hebel JR, Kessler II, Mabuchi K, McCarter RJ. Assessment of hospital performance by use of death rates: A recent case history. JAMA 1982;248:3131.
74. Jollis JG, Ancukiewicz M, DeLong ER, Pryor DB, Muhibaier LH, Mark DB. Discordance of databases designed for claims payment versus clinical information systems: Implications for outcomes research. Ann Intern Med 1993;119:844.
75. Fleming ST, Hicks LL, Bailey RC. Interpreting the Health Care Financing Administration's mortality statistics. Med Care 1995;33:186.
76. Davis RB, Iezzoni LI, Phillips RS, Reiley P, Coffman GA, Safran C. Predicting in-hospital mortality. The importance of functional status information. Med Care 1995;33:906.
77. Grayboys TB, Biegelsen B, Lampert S, Blatt CM, Lown B. Results of a second-opinion trial among patients recommended for coronary angiography. JAMA 1992;268:2537.
78. Greenfield S. The state of outcome research: Are we on target? N Engl J Med 1989;320:1142. Editorial.
79. Roper WL, Hackbarth GM. HCFA's agenda for promoting high-quality care. Health Affairs 1988;7:91.
80. Steiner CA, Bass ER, Talamini MA, Pitt HA, Steinberg EP. Surgical rates and operative mortality for open and laparoscopic cholecystectomy in Maryland. N Engl J Med 1994;330:403.
81. Best WR, Cowper DC. The ratio of observed-to-expected mortality as a quality of care indicator in non-surgical VA patients. Med Care 1994;32:390.
82. Iezzoni LI, Daley J, Heeren T, Foley SM, Fisher ES, Duncan C, et al. Identifying complications of care using administrative data. Med Care 1994;32:700.
83. Mark DB, Lam LC, Lee KL, Jones RH, Pryor DB, Stack RS, et al. Effects of coronary angioplasty, coronary bypass surgery, and medical therapy on employment in patients with coronary artery disease. Ann Intern Med 1994;120:111.
84. Guyatt GH. Measurement of health-related quality of life in heart failure. J Am Coll Cardiol 22:185A.
85. Cotton P. Determining more good than harm is not easy. JAMA 1993;270:153.
86. Moses LE. The evaluation of hospital death rates. JAMA 1986;255:2801. Editorial.