Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Risk adjustment using administrative data - Impact of a diagnosis-type indicator
Autore:
Ghali, WA; Quan, H; Brant, R;
Indirizzi:
Univ Calgary, Dept Med, Fac Med, Calgary, AB, Canada Univ Calgary CalgaryAB Canada y, Dept Med, Fac Med, Calgary, AB, Canada Univ Calgary, Dept Community Hlth Sci, Fac Med, Calgary, AB, Canada Univ Calgary Calgary AB Canada ty Hlth Sci, Fac Med, Calgary, AB, Canada
Titolo Testata:
JOURNAL OF GENERAL INTERNAL MEDICINE
fascicolo: 8, volume: 16, anno: 2001,
pagine: 519 - 524
SICI:
0884-8734(200108)16:8<519:RAUAD->2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
CLINICAL COMORBIDITY INDEX; HOSPITAL MORTALITY-RATES; SURGERY; CANADA; DEATHS;
Keywords:
administrative data; risk adjustment; complications; comorbidities; coronary artery bypass graft surgery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Ghali, WA 3330 Hosp Dr NW, Calgary, AB T2N 4N1, Canada 3330 Hosp Dr NW Calgary AB Canada T2N 4N1 y, AB T2N 4N1, Canada
Citazione:
W.A. Ghali et al., "Risk adjustment using administrative data - Impact of a diagnosis-type indicator", J GEN INT M, 16(8), 2001, pp. 519-524

Abstract

OBJECTIVES: To determine the frequency with which commonly coded clinical variables are complications, as opposed to baseline comorbidities, and to compare the results of 2 risk-adjusted outcome analyses for coronary artery bypass graft surgery for which we either (a) ignored, or (b) used the available "diagnosis-type indicator. "DESIGN. Analysis of existing administrative data. SETTING: Twenty-three Canadian hospitals. PATIENTS: A total of 50,357 coronary artery bypass graft surgery cases. MEASUREMENTS AND MAIN RESULTS: Among 21 clinical variables whose definitions involve the diagnosis-type indicator, 14 were predominantly (greater than or equal to 97%) baseline risk factors when present. Seven variables wereoften complication diagnoses: renal disease (when present, 13% coded as complications), recent myocardial infarction (15%), peptic Weer disease (15%), congestive heart failure (17%), cerebrovascular disease (26%), hemiplegia(34%), and severe liver disease (35%). The results of risk adjustment analyses predicting in-hospital mortality differed when the diagnosis-type indicator was either used or ignored, and as a result, adjusted hospital mortality rates and rankings changed, often dramatically, with rankings increasing for 10 hospitals, decreasing for 9 hospitals, and remaining the same for only 4 hospitals. CONCLUSIONS: The results of analyses performed using the diagnosis-type indicator in Canadian administrative data differ considerably from analyses that ignore the indicator. The widespread introduction of such an indicator should be considered in other countries, because risk-adjustment analyses performed without a diagnosis-type indicator may yield misleading results.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 08:05:31