Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-15T17:36:28.963Z Has data issue: false hasContentIssue false
  • English
  • Français

The Use of Risk-adjusted Complication Rates to Compare Hospitals Performing Coronary Artery Bypass Surgery or Angioplasty

Published online by Cambridge University Press:  14 October 2009

Arthur J. Hartz ,
Evelyn M. Kuhn ,
Robert Green  and
Alfred A. Rimm
Arthur J. Hartz
Affiliation:
Medical College of Wisconsin
Evelyn M. Kuhn
Affiliation:
Medical College of Wisconsin
Robert Green
Affiliation:
Gundersen Clinic, La Crosse, Wisconsin
Alfred A. Rimm
Affiliation:
Medical College of Wisconsin
Get access Rights & Permissions [Opens in a new window]

Abstract

A hospital's quality of care is generally assessed by a review of individual records. This study used unadjusted and risk-adjusted complication rates to measure the quality of care for hospitals that perform coronary artery bypass surgery or angioplasty. Hospitals differed greatly in their complication rates. Only a small percentage of this difference was due to differences in the risks that patients faced.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 8 , Issue 3 , Summer 1992 , pp. 524 - 538
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Brewster, A. C., Karlin, B. G., Hyde, L. A., et al. MEDISGRPS: A clinically based approach to classifying hospital patients at admission. Inquiry, 1985, 22, 377–87.Google ScholarPubMed
2.Chassin, M. R., Park, R. E., Lohr, L. N., et al. Differences among hospitals in Medicare patient mortality. Health Services Research, 1989, 24, 1–31.Google ScholarPubMed
3.Daley, J., Jencks, S., Draper, D., et al. Predicting hospital-associated mortality for Medicare patients. A method for patients with stroke, pneumonia, acute myocardial infarction, and congestive heart failure. Journal of the American Medical Association, 1988, 260, 3617–24.CrossRefGoogle ScholarPubMed
4.Gonnella, J. S., & Goran, M. J.Quality of patient care-A measurement of change: The staging concept. Medical Care, 1975, 13, 467–73.CrossRefGoogle ScholarPubMed
5.Green, J., Wintfeld, N., Sharkey, P., & Passman, L. J.The importance of severity of illness in assessing hospital mortality. Journal of the American Medical Association, 1990, 263, 241–46.CrossRefGoogle ScholarPubMed
6.Hanley, J. A., & McNeil, B. J.A method of comparing the areas under operating characteristic curves derived from the same cases. Radiology, 1983, 148, 839–43.CrossRefGoogle ScholarPubMed
7.Hannan, E. L., Kilburn, H., O'Donnell, J. F., et al. Adult open heart surgery in New York state. An analysis of risk factors and hospital mortality rates. Journal of the American Medical Association, 1990, 264, 2768–74.CrossRefGoogle ScholarPubMed
8.Hartz, A. J.Letter to the Editor, ROC curves. Archives of Pathology and Laboratory Medicine, 1984, 108.Google Scholar
9.Hartz, A. J.Overlap index: An alternative to sensitivity and specificity in comparing the utility of a laboratory test. Archives of Pathology and Laboratory Medicine, 1984, 108, 65–67.Google ScholarPubMed
10.Hartz, A. J., Krakauer, H., Kuhn, E. M., et al. Hospital characteristics and mortality rates. New England Journal of Medicine, 1989, 321, 1720–25.CrossRefGoogle ScholarPubMed
11.Horn, S. D.Physician profiling. How it can be misleading and what to do. Consultant, 1987, 27, 86–94.Google ScholarPubMed
12.Horn, S. D., & Horn, A.Reliability and validity of the Severity of Illness Index. Medical Care, 1986, 24, 159–78.CrossRefGoogle ScholarPubMed
13.Iezzoni, L. L., Ash, A. S., Coffman, G., & Moskowitz, M. A.Admission and mid-stay MedisGroups scores as predictors of death within 30 days of hospital admission. American Journal of Public Health, 1991, 81, 74–78.CrossRefGoogle ScholarPubMed
14.Kennedy, J. W., Kaiser, G. C., & Fisher, L. D.Multivariate discriminant analysis of the clinical and angiographic predictors of operative mortality from the Collaborative Study in Coronary Artery Surgery (CASS). Journal of Thoracic and Cardiovascual Surgery, 1980, 80, 876–87.CrossRefGoogle Scholar
15.Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E.APACHE II: A severity of disease classification. Critical Care Medicine, 1985, 13, 818–29.CrossRefGoogle ScholarPubMed
16.Lemeshow, S., Teres, D., Avrunin, J. S., Pastides, H.Predicting the outcome of intensive care unit patients. Journal of the American Statistical Association, 1988, 83, 348–56.CrossRefGoogle Scholar
17.Schlesselman, J. J.Case control studies. New York: Oxford University Press, 1982.Google Scholar