Citation

Clark DE, Hannan EL, Raudenbush SW. Health Serv. Res. 2010; 45(2): 577-587.

Affiliation

Department of Surgery, Maine Medical Center, 887 Congress Street, Suite 210, Portland, ME 04102, USA.

Copyright

(Copyright © 2010, John Wiley and Sons)

DOI

10.1111/j.1475-6773.2009.01074.x

PMID

20070388

PMCID

PMC2838162

Abstract

OBJECTIVE: To provide a method for any hospital to evaluate patient mortality using a hierarchical risk-adjustment equation derived from a reference sample. DATA SOURCE: American College of Surgeons National Trauma Data Bank (NTDB). STUDY DESIGN: Hierarchical logistic regression models predicting mortality were estimated from NTDB data. Risk-adjusted hospital effects obtained directly from models using standard software were compared with approximations derived from a summary equation and data from each individual hospital. PRINCIPAL FINDINGS: Theoretical approximations were similar to results using standard software.

CONCLUSIONS: To allow independent verification, agencies using reference databases for hospital mortality "report cards" should publish their risk-adjustment equations. Similar hospitals not in the reference database may also use the published equations along with the approximations described to evaluate their own outcomes using their own data.

Language: en