Using a hierarchical model to estimate risk-adjusted mortality for hospitals not included in the reference sample.

ABSTRACT:

Objective

To provide a method for any hospital to evaluate patient mortality using a hierarchical risk-adjustment equation derived from a reference sample.

Data source

American College of Surgeons National Trauma Data Bank (NTDB).

Study design

Hierarchical logistic regression models predicting mortality were estimated from NTDB data. Risk-adjusted hospital effects obtained directly from models using standard software were compared with approximations derived from a summary equation and data from each individual hospital.

Principal findings

Theoretical approximations were similar to results using standard software.

Conclusions

To allow independent verification, agencies using reference databases for hospital mortality "report cards" should publish their r

SUBMITTER: Clark DE 

PROVIDER: S-EPMC2838162 | biostudies-literature | 2010 Apr

REPOSITORIES: biostudies-literature