Development of a data-driven case-mix adjustment model for comparison of hospital performance in hip fracture care

Autor: Wurdemann, F.S., Elfrink, A.K.E., Wilschut, J.A., Brand, C.L. van den, Schipper, I.B., Hegeman, J.H.
Přispěvatelé: Surgery, Public Health, Emergency Medicine
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Archives of Osteoporosis, 17(1):73. Springer London
Würdemann, F S, Elfrink, A K E, Wilschut, J A, van den Brand, C L, Schipper, I B & Hegeman, J H 2022, ' Development of a data-driven case-mix adjustment model for comparison of hospital performance in hip fracture care ', Archives of Osteoporosis, vol. 17, no. 1, 73 . https://doi.org/10.1007/s11657-022-01094-w
Archives of osteoporosis, 17:73. SPRINGER LONDON LTD
Archives of Osteoporosis, 17(1). SPRINGER LONDON LTD
ISSN: 1862-3522
DOI: 10.1007/s11657-022-01094-w
Popis: Summary To compare hospitals’ hip fracture patient mortality in a quality of care registry, correction for patient characteristics is needed. This study evaluates in 39,374 patients which characteristics are associated with 30 and 90-day mortality, and showed how using these characteristics in a case mix-model changes hospital comparisons within the Netherlands. Purpose Mortality rates after hip fracture surgery are considerable and may be influenced by patient characteristics. This study aims to evaluate hospital variation regarding patient demographics and disease burden, to develop a case-mix adjustment model to analyse differences in hip fracture patients’ mortality to calculate case-mix adjusted hospital-specific mortality rates. Methods Data were derived from 64 hospitals participating in the Dutch Hip Fracture Audit (DHFA). Adult hip fracture patients registered in 2017–2019 were included. Variation of case-mix factors between hospitals was analysed, and the association between case-mix factors and mortality at 30 and 90 days was determined through regression models. Results There were 39,374 patients included. Significant variation in case-mix factors amongst hospitals was found for age ≥ 80 (range 25.8–72.1% p p p p p p p p p p Conclusions Dutch hospitals show significant case-mix variation regarding hip fracture patients. Case-mix adjustment is a prerequisite when comparing hospitals’ 30-day and 90-day hip fracture patients’ mortality. Adjusted mortality may serve as a starting point for improving hip fracture care.
Databáze: OpenAIRE
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