Adjusting Quality Rankings for Patient Socioeconomic Characteristics

• Activity Number: 161 - Practical and Methodological Issues Related to Profiling Hospitals in the United States
• Type: Topic Contributed
• Date/Time: Monday, July 30, 2018 : 10:30 AM to 12:20 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Alan Zaslavsky*
• Companies: Harvard University Medical School
• Keywords: hospital quality; socioeconomic factors ; health care; multilevel models; multivariate methods

Abstract

Adjusting hospital quality ratings for socioeconomic factors has been controversial on a number of grounds: policy, practical, principle, inferential and conceptual. This presentation will review these arguments. Focusing on our research on predictors of hospital readmissions, we will discuss methods for analyzing the joint influence of groups of quality predictors in a multilevel modeling framework. We conclude that there are good reasons to adjust, but the best policy outcomes require a broader consideration of incentives and distributional effects such quality adjustments.