Investigating Risk Adjustment Methods for Health Care Provider Profiling When Observations are Scarce or Events Rare.

ABSTRACT:

Background

When profiling health care providers, adjustment for case-mix is essential. However, conventional risk adjustment methods may perform poorly, especially when provider volumes are small or events rare. Propensity score (PS) methods, commonly used in observational studies of binary treatments, have been shown to perform well when the amount of observations and/or events are low and can be extended to a multiple provider setting. The objective of this study was to evaluate the performance of different risk adjustment methods when profiling multiple health care providers that perform highly protocolized procedures, such as coronary artery bypass grafting.

Methods

In a simulation study, provider effects estimated using PS adjustment, PS weighting, PS matching, and mult

SUBMITTER: Brakenhoff TB 

PROVIDER: S-EPMC6069022 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature