Risk-adjusted mortality rates as a potential outcome indicator for outpatient quality assessments

Medical Care

Volumn 40, Issue 3, 2002, Pages 237-245

  Selim, Alfredo J ^a,c   Berlowitz, Dan R ^a,b,c   Fincke, Graeme ^a,c   Rosen, Amy K ^a,c   Renc, Xinhua S ^a,c   Christiansen, Cindy L ^a,c   Cong, Zhongxhiao ^a   Lee, Austin ^a,d   Kazis, Lewis ^a,c  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b BOSTON MEDICAL CENTER   (United States)

^c BOSTON UNIVERSITY   (United States)

^d Boston University   (United States)

Author keywords

Case mix; Mortality; Outpatient care; Quality of care; Risk adjustment

Indexed keywords

AGED; AMBULATORY CARE; ARTICLE; CHI SQUARE DISTRIBUTION; FEMALE; HEALTH CARE QUALITY; HEALTH SERVICES RESEARCH; HUMAN; MALE; METHODOLOGY; MIDDLE AGED; MORTALITY; OUTCOME ASSESSMENT; PUBLIC HOSPITAL; RISK ASSESSMENT; STANDARD; STATISTICAL MODEL; UNITED STATES;

AGED; AMBULATORY CARE; CHI-SQUARE DISTRIBUTION; FEMALE; HEALTH SERVICES RESEARCH; HOSPITALS, VETERANS; HUMANS; LOGISTIC MODELS; MALE; MIDDLE AGED; MORTALITY; OUTCOME ASSESSMENT (HEALTH CARE); QUALITY OF HEALTH CARE; RISK ADJUSTMENT; UNITED STATES;

EID: 0036517128     PISSN: 00257079     EISSN: None     Source Type: Journal    
DOI: 10.1097/00005650-200203000-00007     Document Type: Article

References (66)

1. Sivak ED, Rogers MA. Assessing quality of care using in-hospital mortality: does it yield informed choices. Chest 1999;115:613-614.
2. Thomas JW, Holloway JJ, Guire KE. Validating risk-adjusted mortality as an indicator tor quality of care. Inquiry 1993;30:6-22.
3. Best WR, Cowper DC. The ratio of observed-to-expected mortality as a quality of care indicator in nonsurgical VA patients. Med Care 1994;32:390-400.
4. Daley J, Jencks S, Draper D, et al. Predicting hospital-associated mortality for Medicare patients. JAMA 1988;260:3617-3624.
5. Benson DS. Measuring Outcomes in Ambulatory Care. Chicago, IL: American Hospital Publishing; 1992.
6. Kazis L, Miller D, Clark J, et al. Health related quality of life in patients served by the Department of Veterans Affairs: Results from the Veterans Health Study. Arch of Intern Med 1998;158:626-638.
7. Verbrugge LM, Patrick DL. Seven chronic conditions: their impact on US adults' activity levels and use of medical services. Am J Public Health 1995;85:173-182.
8. Sanderson C, Dixon JJ. Conditions for which onset or hospital admission is potentially preventable by timely and effective ambulatory care. Health Serv Res Policy 2000;5:222-230.
9. Roemer M. Ambulatory health services in America. Rockville, MD: Aspen Systems Corporation; 1981.
10. Phillips KA, Shlipak MG, Coxson P, et al. Health and economic benefits of increased beta-blocker use following myocardial infarction. JAMA 2000;284:2748-2754.
11. Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group N Engl J Med 1995;333:1301-1307.
12. Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. Results of AFCAPS/TexCAPS. JAMA 1998;279:1615-1622.
13. Hennekens CH, Dyken ML, Fuster V. Aspirin as a therapeutic agent in cardiovascular disease: A statement of health care professionals from the American Heart Association. Circulation 1997; 96:2751-2753.
14. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992;327:685-691.
15. Sin DD, Tu JV. Outpatient antibiotic therapy and short-term mortality in elderly patients with chronic obstructive pulmonary disease. Can Respir J 2000;7:466-471
16. Hobbs FD. Management of heart failure: evidence versus practice. Does current prescribing provide optimal treatment for heart failure patients? Br J Gen Pract 2000;50:735-742.
17. Griffin S, Kinmonth AL Cochrane. Diabetes care: the effectiveness of systems for routine surveillance for people with diabetes. Database Syst Rev 2000;(2):CD000541
18. Leape LL. Error in medicine JAMA 1994;272:1851-1857.
19. Reason J. Human error: models and management. BMJ 2000;320:768-770.
20. Iezzoni LI. The risks of risk adjustment. JAMA 1997;278:1600-1607.
21. Green J, Wintfeld N, Sharkey P, et al. The importance of severity of illness in assessing hospital mortality. JAMA 1990;263:241-246.
22. Berlowitz DR, Rosen AK, Moskowitz MA. Ambulatory care case-mix measures. J Gen Intern Med 1995;10:162-170.
23. Salem-Schatz S, Moore G, Rucker M, et al. The case for case-mix adjustment in practice profiling. JAMA 1994;272:871-874.
24. Starfield B, Weiner J, Mumford L, et al. Ambulatory care groups: a categorization of diagnoses for research and management. Health Serv Res 1991;26:53-74.
25. Iezzoni LI, ed. Risk Adjustment for Measuring Health Care Outcomes, 2d ed. Chicago, IL: Health Administration Press; 1997.
26. Fetter RB, Averill RF, Lichtenstein JL, et al. Ambulatory Visit Groups: a framework for measuring productivity in ambulatory care. Health Serv Res 1984;19:415-437.
27. Tucker AM, Weiner JP, Honigffeld, et al. Profiling primary care physician resource use: Examining the application of case mix adjustment. J Ambulatory Care Manage 1996;19:60-80.
28. Weiner JP, Starfield BH, Powe NR, et al. Ambulatory care practice variation within a Medicaid program. Health Serv Res 1996;30:751-770.
29. Weiner JP, Starfield BH, Seinwachs DM, et al. Development and application of a population-oriented measure of ambulatory care case-mix. Med Care 1991;29:452-472.
30. Tenan PM, Fillmore HH, Caress B, et al. PACs: Classifying ambulatory care patients and services for clinical and financial management. J Ambulatory Care Manage 1988;11:36-53.
31. Tierney WM, Takesue BY, Vargo DL, et al. Using electronic medical records to predict mortality in primary care patients with heart disease: prognostic power and pathophysiologic implications. J Gen Intern Med 1996;11:83-91
32. Iezzoni LI, Ash AS, Coffman GA, et al. Predict ing in-hospital mortality: a comparison of severity measurement approaches. Med Care 1992;30:347-359.
33. Young WW, Swinkola RB, Zorn DM. The measurement of hospital case mix. Med Care 1982;20:501-512.
34. Iezzoni LI, Ash AS, Swartz M, et al. Judging hospitals by severity-adjusted mortality rates: the influence of the severity-adjustment method. Am J Public Health 1996;86:1379-1387.
35. Kizer KW, Demakis JG, Feussner JR. Reinvent ing VA Health Care: Systematizing quality improvement and quality innovation. Med Care 2000;38(suppl 6):I7-I16.
36. Kazis LE, Skinner K, Rogers W, et al. Health status and outcomes of Veterans: Physical and Mental component summary scores (SF-36V) 1998 National Survey of Ambulatory Care Patients: Mid-Year Excutive Report. Washington, D.C. Department of Veterans Affairs: Veterans Health Administration Office of Performance and Quality. 1998.
37. Boyle CA, Dcoufle P. National sources of vital status information: extent of coverage and possible selectivity in reporting. Am J Epidemiol 1990;131:160-168.
38. Ashton CM, Menke TJ, Deykin D, et al. A state-of-the-art conference on databases pertaining to veterans' health. A resource for research and decision making. Med Care 1996;34:MS1-8.
39. Wray NP, Hollingsworth JC, Petersen NJ, et al. Case-mix adjustment using administrative databases: a paradigm to guide future research. Med Care Res Rev 1997;54:326-356.
40. Hornbrook MC, Goodman MJ. Chronic disease, functional health status, and demographics: a multidimensional approach to risk adjustment. Health Serv Res 1996;31:283-307.
41. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992;45:613-619.
42. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 1987;40:373-383.
43. Rumsfeld JS, Ma Whinney S, McCarthy Jr. M, et al. Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. JAMA 1999;281:1298-1303.
44. Inouye SK, Peduzzi PN, Robinson JT, et al. Importance of functional measures in predicting mortality among older hospitalized patients. JAMA 1998;279:1187-1193.
45. Ware J, Kosinski M, Keller S. SF-36 Physical and Mental Health Summary Scales: A User's Manual. 2nd ed. Boston, Mass: The Health Institute, New England Medical Center; 1994.
46. Stewart AL, Hays RD, Ware JE Jr. The MOS Short-Form General Health Survey. Reliability and validity in a patient population. Med Care 1988;6:724-736.
47. Kazis LE, Miller D, Skinner K, et al. Improving the response choices on the sf-36 role functioning scales: results from the veterans health study. Med Care. In press.
48. Ware JE, Kosinski M, Bayliss MS, et al. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 1995;33:AS264-AS279.
49. Kazis LE, Skinner K, Rogers W, et al. Health status and outcomes of Veterans: Physical and Mental component summary scores (SF-36V) 1998 National Survey of Ambulatory Care Patients: Mid-Year Executive Report. Washington, D.C. Department of Veterans Affairs: Veterans Health Administration Office of Performance and Quality. 1998.
50. Cody RP, Smith JK. Applied statistics and the SAS programming language. 3rd ed. New Jersey: Prentice-Hall, 1991.
51. Hamilton LC. Regression with graphics: a second course of applied statistics. Pacific Grove, CA: Duxbury Press; 1992.
52. Efron B, Tibshirani RJ. An introduction to the Bootstrap. New York, NY: Chapman & Hall; 1993:45-46.
53. Hosmer EW, Lemeshow S. Applied Logistic Regression. New York, NY: Wiley; 1989.
54. Berlowitz DR, Ash AS, Hickey EC, et al. Profiling outcomes of ambulatory care: case-mix affects perceived performance. Med Care 1998;36:928-933.
55. Christiansen CL, Morris CN. Improving the statistical approach to health care provider profiling. Ann Intern Med 1997;127:764-768.
56. SAS Language: Reference, Version 6, 1st ed. Cary, NC: SAS Institute; 1990.
57. Asch SM, Sloss EM, Hogan C, et al. Measuring underuse of necessary care among elderly Medicare beneficiaries using inpatient and outpatient claims. JAMA 2000;284:2374-2376.
58. Joint Commission on Accreditation of Healthcare Organizations. Ambulatory Health Care Standards Manual. Chicago, IL: JCAHO; 1990.
59. Malmgren JA, Koepsell TD, Martin DP, et al. Mortality, health services use, and health behavior in a cohort of well older adults. J Am Geriatr Soc 1999 Jan;47:51-59.
60. Dubois RW, Rogers WH, Moxley JH 3rd, et al. Hospital inpatient mortality: Is it a predictor of quality. N Engl J Med 1987;317:1674-1680.
61. William TJ, Hofer TP. Accuracy of risk-adjusted mortality rate as a measure of hospital quality of care. Med Care 1999;37:83-92.
62. Flood AB. Peaks and pits of using large data bases to measure quality of care. Intl J Technology Assessment Health Care 1990;6:253-262.
63. Lillard LA, Farmer MM. Linking Medicare and national survey data. Ann Intern Med 1997;127:691-695.
64. Pine M, Norusis M, Jones B, Rosenthal GE. Predictions of hospital mortality rates: a comparison of data sources. Ann Intern Med 1997;126:347-354.
65. Khuri SF, Daley J, Henderson W, et al. The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg 1995;180:607-609.
66. Selker HP. Systems for comparing actual and predicted mortality rates: characteristics to promote cooperation in improving hospital care. Ann Intern Med 1993;118:820-822.