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Activity Number: 27
Type: Topic Contributed
Date/Time: Sunday, August 4, 2013 : 2:00 PM to 3:50 PM
Sponsor: Section for Statistical Programmers and Analysts
Abstract - #310020
Title: Variation in Quality by Hospital Characteristics: True or False?
Author(s): David Jones*+ and Sam Stalley and Alex Bohl and Frank B Yoon and Eric Schone and Joe Zickafoose and Jessica Ross
Companies: Mathematica Policy Research and Mathematica Policy Research and Mathematica Policy Research and Mathematica Policy Research and Mathematica Policy Research and Mathematica Policy Research and Mathematica Policy Research
Keywords: Health Policy ; Hospital Quality Indicators
Abstract:

Recent critiques of the AHRQ QIs in the academic literature and popular press have called into question the validity of the indicators in making comparisons of hospital quality. A key component of the critiques is the assertion that certain hospital types are fundamentally different in their mission, patient populations, and service delivery. These assertions are typically supported by limited evidence that the group means of the QIs (average risk- and reliability-adjusted point estimates) vary by hospital characteristics. We present a systematic review of the variation in the QIs by hospital characteristics. We add to the evidence base by considering the estimated variance of the risk- and reliability-adjusted rates when testing the differences between hospital group means. We also compare the distributions of hospital performance categories reported on CMS's Hospital Compare website (an alternate way of comparing hospitals) to determine if there is variation by hospital groups. Finally, we explore sources of the observed differences in a multivariate framework, by estimating the degree to which various hospital characteristics drive the variation in hospital results.


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