The study, published in the American Journal of Managed Care, examined the performance reports and 30-day mortality rates of VA hospitals from 2006 to 2010. It also obtained Medicare fee-for-service data to create “complete risk” profiles for patients 66 and older who were not in a VA hospice program, finding that hospital performance reports are modestly affected by fragmented records.
Patients who come into the VA hospitals and do not provide their records have a less complete medical history for treatment. If those patients die within 30 days of a VA hospitalization, it could negatively affect the hospital’s performance, regardless of whether the patient was high-risk or not, according to the study.
“When patients use different systems for distinct medical problems, single data source assessments can miss important differences in patient risk that could bias performance measures; in this case, pooled data should add consequential new clinical information,” the researchers wrote. “If hospitals vary substantially in how much of their patients’ data is unobserved, single-source hospital profiles could disadvantage facilities whose patients’ data are particularly incomplete.”
