IDEAS home Printed from https://ideas.repec.org/a/aph/ajpbhl/199686101379-1387_5.html
   My bibliography  Save this article

Judging hospitals by severity-adjusted mortality rates: The influence of the severity-adjustment method

Author

Listed:
  • Iezzoni, L.I.
  • Ash, A.S.
  • Shwartz, M.
  • Daley, J.
  • Hughes, J.S.
  • Mackieman, Y.D.

Abstract

Objectives. This research examined whether judgments about a hospital's risk-adjusted mortality performance are affected by the severity-adjustment method. Methods. Data came from 100 acute care hospitals nationwide and 11 880 adults admitted in 1991 for acute myocardial infarction. Ten severity measures were used in separate multivariable logistic models predicting in- hospital death. Observed-to-expected death rates and z scores were calculated with each severity measure for each hospital. Results. Unadjusted mortality rates for the 100 hospitals ranged from 4.8% to 26.4%. For 32 hospitals, observed mortality rates differed significantly from expected rates for I or more, but not for all 10, severity measures. Agreement between pairs of severity measures on whether hospitals were flagged as statistical mortality outliers ranged from fair to good. Severity measures based on medical records frequently disagreed with measures based on discharge abstracts. Conclusions. Although the 10 severity measures agreed about relative hospital performance more often than would be expected by chance, assessments of individual hospital mortality rates varied by different severity-adjustment methods.

Suggested Citation

  • Iezzoni, L.I. & Ash, A.S. & Shwartz, M. & Daley, J. & Hughes, J.S. & Mackieman, Y.D., 1996. "Judging hospitals by severity-adjusted mortality rates: The influence of the severity-adjustment method," American Journal of Public Health, American Public Health Association, vol. 86(10), pages 1379-1387.
    • Handle: RePEc:aph:ajpbhl:1996:86:10:1379-1387_5
    as

    Download full text from publisher

    To our knowledge, this item is not available for download. To find whether it is available, there are three options:
    1. Check below whether another version of this item is available online.
    2. Check on the provider's web page whether it is in fact available.
    3. Perform a search for a similarly titled item that would be available.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Wang, Justin & Hockenberry, Jason & Chou, Shin-Yi & Yang, Muzhe, 2011. "Do bad report cards have consequences? Impacts of publicly reported provider quality information on the CABG market in Pennsylvania," Journal of Health Economics, Elsevier, vol. 30(2), pages 392-407, March.
    2. Paolo Berta & Gianmaria Martini & Francesco Moscone & Giorgio Vittadini, 2016. "The association between asymmetric information, hospital competition and quality of healthcare: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 907-926, October.
    3. Courty, Pascal & Kim, Do Han & Marschke, Gerald, 2011. "Curbing cream-skimming: Evidence on enrolment incentives," Labour Economics, Elsevier, vol. 18(5), pages 643-655, October.
    4. Paolo Berta & Chiara Seghieri & Giorgio Vittadini, 2013. "Comparing health outcomes among hospitals: the experience of the Lombardy Region," Health Care Management Science, Springer, vol. 16(3), pages 245-257, September.
    5. Ricardo Castro & Pedro Oliveira & Conceição Silva Portela & Ana Camanho & João Queiroz e Melo, 2015. "Benchmarking clinical practice in surgery: looking beyond traditional mortality rates," Health Care Management Science, Springer, vol. 18(4), pages 431-443, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:aph:ajpbhl:1996:86:10:1379-1387_5. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Christopher F Baum (email available below). General contact details of provider: https://www.apha.org .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.