Risk adjustment for coronary artery bypass graft surgery: an administrative approach versus EuroSCORE

Abstract

Adding some administrative variables considered proxy for clinical complexity to the administrative model and linking hospital data across patients' multiple episodes of care eliminated much of the difference in effectiveness between the clinical and administrative risk adjustment approach. Focusing on the health policy context of measuring CABG death rates, our study strengthened the thesis that, with the growing improvement in accurate coding practice, administrative databases could provide a valuable and economical source for health planning and research.

P.Re.Val.E.: outcome research program for the evaluation of health care quality in Lazio, Italy

“…In Italy, initiatives aimed at assessing the outcomes of hospital care have been undertaken at the national and regional levels only in the last decade [13,17,40,41]. Based on these experiences, we developed the Regional Outcome Evaluation Program, called P.Re.Val.E.…”

Risk adjusted resource utilization for AMI patients treated in Japanese hospitals

“…They theorized that measures based on administrative data might perform better because of confusion in coding between complications and comorbidities. However, a recent study by Ugolini and Nobilio, which went to great lengths to distinguish between comorbidities and complications among secondary diagnoses by linking administrative records across admissions, found that a statistical model based on clinical data did not have a substantially better predictive ability than a model based on administrative data to predict in-hospital mortality following CABG surgery (Ugolini and Nobilio, 2004). Though our study address a somewhat different domain -resource utilization for AMI patients as opposed to mortality for CABG patients -it is at least clear that clinical data are not universally superior to administrative data for modeling aspects of healthcare delivery.…”

Comparison of risk-adjustment models using administrative or clinical data for outcome prediction in patients after myocardial infarction or coronary bypass surgery in Korea

“…Instead, we identified comorbidities and past operation histories from earlier admissions. Using this method, it was likely that our risk‐adjustment model based on administrative data identified comorbidities more accurately than previous studies, which included potential complication diagnosis codes in same admission claims (4,16,17).…”