Combining Administrative and Clinical Data to Stratify Surgical Risk

Abstract

Enhancement of ADM with POA codes and readily available laboratory data can efficiently support accurate risk-stratified measurements of clinical outcomes in surgical patients.

Patient Characteristics and the Occurrence of Never Events

“…To avoid denial of care to high-risk patients, payments should be adjusted to reflect the predicted incidence and cost of complications based on patient and disease characteristics and on planned procedural interventions. Both of these goals can be achieved readily through the use of risk-adjusted warranties that link financial rewards and penalties to the Using analytic techniques such as those in this study, and with the use of refined data sets that include presenton-admission coding and available clinical information, 14 providers with low risk-adjusted complication rates can be identified. Predictive equations for potentially avoidable complications can be standardized using only data from these high-quality providers.…”

Despite Overall Improvement In Surgical Outcomes Since 2000, Income-Related Disparities Persist

“…33 Our adjustment for clinical status, using administrative data, may not have adequately adjusted for these factors. Future research could employ more detailed clinical information 34 to examine whether unmeasured clinical factors explain the disparities.…”

Current challenges in the recognition, prevention and treatment of perioperative pulmonary atelectasis

“…Patient-related factors that influence PPCs risk include presence of cardiovascular disease, chronic obstructive pulmonary disease (COPD), neuromuscular/neuromotor disorders, renal failure, malignancy and autoimmune disease [1,2,4,12, 47,48]. Additional factors include recent respiratory illness, traumatic injury, a history of tobacco smoking, obesity and age [4,41,49].…”