Improving Risk Adjustment in the Assessment of Congenital Heart Center Surgical Quality.

ABSTRACT:

Background

Understanding center performance in congenital heart surgery remains challenging, with limitations to standard regression approaches. Modern causal inference methods may improve estimation of expected mortality through better balancing case-mix but have not been studied.

Methods

Benchmark operations (BMO) across 115 centers (2016-2022) from the STS Congenital Database were included. The standard approach uses mixed-effects logistic regression to estimate center's expected operative mortality inclusive of all patients, even those treated at the center of interest ("target") and those from other centers regardless of how closely aligned with the target. The causal approach creates tailored comparison groups, including only like patients from other centers using weig

SUBMITTER: Normand SL 

PROVIDER: S-EPMC12513556 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature