Ranking hospitals on surgical mortality: the importance of reliability adjustment.

ABSTRACT:

Objective

We examined the implications of reliability adjustment on hospital mortality with surgery.

Data source

We used national Medicare data (2003-2006) for three surgical procedures: coronary artery bypass grafting (CABG), abdominal aortic aneurysm (AAA) repair, and pancreatic resection.

Study design

We conducted an observational study to evaluate the impact of reliability adjustment on hospital mortality rankings. Using hierarchical modeling, we adjusted hospital mortality for reliability using empirical Bayes techniques. We assessed the implication of this adjustment on the apparent variation across hospitals and the ability of historical hospital mortality rates (2003-2004) to forecast future mortality (2005-2006).

Principal findings

The net effect of re

SUBMITTER: Dimick JB 

PROVIDER: S-EPMC2976775 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature