Determining population based mortality risk in the Department of Veterans Affairs
| Autor: | Marta L. Render, Eileen Moran, Laura Lehner, Peter L. Almenoff, Theodore Stefos |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Gerontology Statistics as Topic Population Medicine (miscellaneous) Risk Assessment Health administration Decile Sex Factors Case mix index Risk Factors Humans Medicine Hospital Mortality education Veterans Affairs Diagnosis-Related Groups Veterans education.field_of_study Receiver operating characteristic business.industry Mortality rate Multilevel model Age Factors Middle Aged United States United States Department of Veterans Affairs ROC Curve Socioeconomic Factors Chronic Disease General Health Professions Female business Demography |
| Zdroj: | Health Care Management Science. 15:121-137 |
| ISSN: | 1572-9389 1386-9620 |
| DOI: | 10.1007/s10729-011-9189-0 |
| Popis: | We develop a patient level hierarchical regression model using administrative claims data to assess mortality outcomes for a national VA population. This model, which complements more traditional process driven performance measures, includes demographic variables and disease specific measures of risk classified by Diagnostic Cost Groups (DCGs). Results indicate some ability to discriminate survivors and non-survivors with an area under the Receiver Operating Characteristic Curve (C-statistic) of .86. Observed to expected mortality ranges from .86 to 1.12 across predicted mortality deciles while Risk Standardized Mortality Rates (RSMRs) range from .76 to 1.29 across 145 VA hospitals. Further research is necessary to understand mortality variation which persists even after adjusting for case mix differences. Future work is also necessary to examine the role of personal behaviors on patient outcomes and the potential impact on population survival rates from changes in treatment policy and infrastructure investment. Health Care Manag Sci |
| Databáze: | OpenAIRE |
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