Abstract #301570

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JSM 2003 Abstract #301570
Activity Number: 352
Type: Invited
Date/Time: Wednesday, August 6, 2003 : 10:30 AM to 12:20 PM
Sponsor: Section on Health Policy Statistics
Abstract - #301570
Title: Statistical Models for Monitoring/Surveillance and Public Reporting
Author(s): Sharon-Lise Normand*+ and Harlan M. Krumholz and Jennifer Mattera and Deb Ralston and Amy Rich and Yongfei Wang and Yun Wang
Companies: Harvard University Medical School and Yale University and Colorado Foundation for Medical Care and Yale University and Yale University and Yale University
Address: Dept. of Health Care Policy, Boston, MA, 02115-5821,
Keywords: discrimination ; hierarchical model ; calibration ; ROC area ; shrinkage
Abstract:

The Healthcare Research and Quality Act of 1999 mandated the Agency for Healthcare Research and Quality produce a National Quality Report for Congress by fiscal year 2003. The report will be used to inform Congress, providers, and consumers about the state of health care quality; identify conditions requiring improvement in quality; and to provide benchmarks for quality initiatives. We describe a framework for profiling states on the basis of binary-valued outcomes using hierarchical generalized linear models. Methods to assess model performance, both within- and between-states are discussed. We illustrate methods using administrative data for two national Medicare cohorts in order to profile states: 284,819 patients discharged with a heart attack in 1998, and 639,211 patients discharged with heart failure in 1998. Model calibration and discrimination are compared to results using medical chart-abstracted data.

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