The new Risk Stratification Index, made freely available to all institutions, permits outcomes such as hospital length of stay and mortality to be compared fairly across institutions.
To develop the index, researchers analyzed more than 35 million Medicare records from 2001-2006 and developed highly predictive risk-adjustment models for length-of-stay and in-hospital mortality, 30-day mortality and 1-year mortality. The validity of the system was confirmed through use in the Cleveland Clinic.
The new risk stratification system is more accurate than existing outcomes measurements such as the Charlson Comorbidity Index, said the lead author, Daniel Sessler, MD, chair of the Department of Outcomes Research at the Cleveland Clinic. “Comparisons only make sense after adjusting for baseline risk and the risks associated with different operations,” Dr. Sessler said. “Our Risk Stratification Index allows for an accurate and fair comparison among hospitals using only publicly available data.”
In a release on the article put out by the journal, two anesthesiologists said the new system has some shortcomings in use of Medicare claims database. “Applying RSI methodology to current physician payment administrative claims data will be unlikely to generate as robust a formula for predicting mortality, morbidity or other endpoints as the authors demonstrated here with inpatient data,” Alexander A. Hannenberg, MD, and Norman A. Cohen, MD, noted. “However, the reorganization of Medicare contracting into combined Part A and B Medicare Administrative Contractors has the potential to link patient-specific quality, cost, facility and provider data in a way that could allow a modified RSI to include quality and cost inputs.”
Read the Anesthesiology report on quality measures.
Read more coverage on quality measures:
– Physicians With Low-Income Patients Hampered in Quality Measures
– U.S. News’ Hospital Rankings More Linked to Reputation Than Quality
– Leapfrog’s 2009 List of Top Hospitals Adds Efficiency to Usual Quality Criteria
