Comparison of Mortality Risk Adjustment Using a Clinical Data Algorithm (American College of Surgeons National Surgical Quality Improvement Program) and an Administrative Data Algorithm (Solucient) at the Case Level Within a Single Institution

摘要: Background There is great interest in efficiently evaluating health care quality, but there controversy over the use of administrative versus clinical data methods. We sought to compare actual mortality with risk-adjusted expected a sample population calculated by two different methods; one based on preexisting records and chart reviews. Study Design examined patients (n = 1,234) undergoing surgical procedures at an academic teaching hospital during 1 year. The first risk-adjustment method was that used National Surgical Quality Improvement Program, which dedicated medical record review. second Solucient, LLC, records. Results ratio observed for this set higher using Program algorithm (1.1; 95% CI, 0.8 1.5) than Solucient (0.9; 0.6 1.2) neither estimate notably from 1.0. Similarly, when ratios were separately each quartile mortality, no marked differences within quartiles, although minor potential importance noted. Fit comparable age categories, gender, American Society Anesthesiologists' categories. A number deaths had predicted scores algorithm. Conclusions Risk-adjusted estimates or data. Minor performance might still have implications. Because lower cost data, type can be efficient alternative should continue investigated.