International journal for quality in health care : journal of the International Society for Quality in Health Care
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Int J Qual Health Care · Dec 1998
Multicenter StudyLaboratory values improve predictions of hospital mortality.
To compare the precision of risk adjustment in the measurement of mortality rates using: (i) data in hospitals' electronic discharge abstracts, including data elements that distinguish between comorbidities and complications; (ii) these data plus laboratory values; and (iii) these data plus laboratory values and other clinical data abstracted from medical records. ⋯ In the conditions studied, predictions of inpatient mortality improved noticeably when laboratory values (sometimes available electronically) were combined with administrative data that included only those secondary diagnoses present on admission (i.e. comorbidities). Additional clinical data contribute little more to predictive power.
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Int J Qual Health Care · Jun 1997
Multicenter StudyThe relationship between choice of outcome measure and hospital rank in general surgical procedures: implications for quality assessment.
Institutional complication rates are often used to assess hospital quality of care, particularly for conditions and procedures where mortality rates are not useful because deaths are rare. The objective of this study was to assess the correlation among hospital quality assessment rankings based on adjusted mortality, complication and failure-to-rescue rates. ⋯ For general surgical procedures, hospital rank using the complication rate is poorly correlated with rankings using the death or failure rate. Complication rates should be used with great caution and should not be used in isolation when assessing hospital quality of care.
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Int J Qual Health Care · Jun 1995
Multicenter Study Comparative StudyComparing outcomes and charges for patients with acute myocardial infarction in three community hospitals: an approach for assessing "value".
To assess the value of care (i.e. outcomes in relation to charges) for acute myocardial infarction (Acute MI) patients in three community hospitals after controlling for patient mix differences. ⋯ The "value" profiles (i.e. outcomes related to charges) produced by these three hospitals were substantially different. Studies that simultaneously measure outcomes, costs, patient mix and processes have potential to: (a) enable clinical teams to improve the measurable value of clinical care; and (b) enable purchasers to better evaluate which providers to select as preferred sources of care.