TY  - JOUR
PY  - 2010//
TI  - Using a hierarchical model to estimate risk-adjusted mortality for hospitals not included in the reference sample
JO  - Health services research
A1  - Clark, David E.
A1  - Hannan, Edward L.
A1  - Raudenbush, Stephen W.
SP  - 577
EP  - 587
VL  - 45
IS  - 2
N2  - 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. <br><br>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.<p /> <p>Language: en</p>
LA  - en
SN  - 0017-9124
UR  - http://dx.doi.org/10.1111/j.1475-6773.2009.01074.x
ID  - ref1
ER  -