A Method for Screening the Quality of Hospital Care Using Administrative Data: Preliminary Validation Results

Iezzoni, Lisa I.; Foley, Susan M.; Heeren, Timothy; Daley, Jennifer; Duncan, Charles C.; Hughes, John S.

doi:10.1016/s0097-5990(16)30557-7

Cited by 79 publications

(51 citation statements)

References 33 publications

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“…We identified eligible patients using the International Classification of Diseases, 9th revision (ICD-9) [10] codes for bladder cancer (188.0-188.9 and 236.7) and radical cystectomy or pelvic exenteration (57.7, 57.71, 57.79 and, 68.8). We supplemented the claims data with income information from the US 2000 Census based on the patients' zip codes.…”

Section: Data Sourcesmentioning

confidence: 99%

Gender and age differences in blood utilization and length of stay in radical cystectomy: a population-based study

et al. 2008

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Section: Data Sourcesmentioning

confidence: 99%

Gender and age differences in blood utilization and length of stay in radical cystectomy: a population-based study

et al. 2008

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“…Therefore, these risk pools serve as a mechanism to stratify and/or adjust the risks of various hospital populations. The other purpose is to minimize the potential for false-positive findingsthose suggesting that quality problems are present when actually they do not exist [36,40].…”

Section: Correction For Severity Differencesmentioning

confidence: 99%

Do competition and managed care improve quality?

Sari

2002

Health Economics

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In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital competition on quality using in-hospital complications as quality measures. I use random and fixed effects, and instrumental variable fixed effect models using hospital panel data from up to 16 states in the 1992-1997 period. The paper has two important findings: First, higher managed care penetration increases the quality, when inappropriate utilization, wound infections and adverse/iatrogenic complications are used as quality indicators. For other complication categories, coefficient estimates are statistically insignificant. These findings do not support the straightforward view that increases in managed care penetration are associated with decreases in quality. Second, both higher hospital market share and market concentration are associated with lower quality of care. Hospital mergers have undesirable quality consequences. Appropriate antitrust policies towards mergers should consider not only price and cost but also quality impacts.

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“…Im internationalen Kontext sind seit Langem Berichts-und Qualitätssiche-rungssysteme implementiert, die sich auf administrative Routinedaten, also auf Sekundärdaten, stützen [9]. Die in den USA durch die Agency for Healthcare Research and Quality (AHRQ) bereits in den frü-hen 1990er Jahren validierten Indikatoren zur Patientensicherheit basieren ausschließlich auf administrativen Routinedaten [10].…”

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