Effect of disability, homelessness, and neighborhood marginalization on risk adjustment for hospital performance measurement.

ABSTRACT: It is not known how disability, homelessness, or neighborhood marginalization influence risk-adjusted hospital performance measurement in a universal health care system. In this study, we evaluated the effect of including these equity-related factors in risk-adjustment models for in-hospital mortality, and 7- and 30-day readmission in 28 hospitals in Ontario, Canada. We compared risk adjustment with commonly used clinical factors to models that also included homelessness, disability, and neighborhood indices of marginalization. We evaluated models using historical data using internal-external cross-validation. We calculated risk-standardized outcome rates for each hospital in a recent reporting period using mixed-effects logistic regression. The cohort included 544 805 admissions. Adjustme

SUBMITTER: Roberts SB 

PROVIDER: S-EPMC12634112 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature