Alternative Weighting Schemes for the AHRQ QI Composites

• 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
• Author(s): Eric Schone*+ and Alex Bohl and David Jones and Dmitriy Poznyak and Jessica Ross and Frank B Yoon and Joe Zickafoose
• 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 measures ; Compositing

Abstract

In the current AHRQ QI composite scheme, composites are constructed of weighted averages of smoothed component rates, where components are smoothed to the national mean. The same composite weights are applied to all hospitals regardless of their characteristics. If the true performance of small hospitals is different from the national mean, the current compositing methodology may introduce bias when comparing hospital performance. As part of our research investigating the relation between hospital characteristics to the performance of QI measures, we estimate bias in component values among groups of hospitals defined by different characteristics, including volume. We will carry through our analyses from the component to the composite level by comparing the reliability and total estimated bias of the composite across hospital groups. We will explore several options for combining QI component values and discuss the challenges and strengths of each approach. We will further compare the influence of these weighting schemes on the predictive validity of the AHRQ QI composites.