Which Hospitals Have Significantly Better or Worse Than Expected Mortality Rates for Acute Myocardial Infarction Patients?
Key result
Risk adjustment models using present-at-admission diagnoses identified substantially fewer hospitals as mortality outliers compared to the standard California model.
Why the study?
Does using present-at-admission diagnoses for risk adjustment improve the statistical performance of hospital mortality rate comparisons for acute myocardial infarction patients?
Population
Patients with acute myocardial infarction treated at hospitals in California
Comparison
Patient-level mortality risk adjustment models… vs Logistic regression models originally used by…
Design
Other
Authors
Discussion
Loading...
Member takes
Implication
Present-at-admission adjustment identifies fewer mortality outliers; challenges standard models and supports refined risk adjustment for hospital comparisons.
Study Design
Type
Observational
Multicenter
Yes
Structured PICO
Does using present-at-admission diagnoses for risk adjustment improve the statistical performance of hospital mortality rate comparisons for acute myocardial infarction patients?
P
Population
Patients with acute myocardial infarction treated at hospitals in California
E
Exposure
Patient-level mortality risk adjustment models using present-at-admission diagnoses
C
Comparator
Logistic regression models originally used by California (California model A)
O
Outcome
Identification of hospitals with higher or lower than expected mortality (outliers)
Using present-at-admission diagnoses for risk adjustment significantly improves statistical performance and alters which hospitals are identified as mortality outliers for acute myocardial infarction.
Cite This Study
Stukenborg et al. (2007) conducted an observational in Acute myocardial infarction. Risk adjustment models using present-at-admission diagnoses vs. California model A was evaluated on Identification of hospitals as mortality outliers. Risk adjustment models using present-at-admission diagnoses identified substantially fewer hospitals as mortality outliers compared to the standard California model.