Using administrative databases to evaluate the quality of medical care: A conceptual framework

摘要: Health care is consuming an ever larger share of national resources in the United States. Measures to contain costs and evidence unexplained variation patient outcomes have led concern about inadequacy quality health care. As a measure quality, evaluation hospitals through analysis their discharge databases has been suggested because scope economy offered by this methodology. However, value information obtained these analyses questioned clinical data contained administrative resultant inability control accurately for variation. We suggest, however, that major shortcoming prior attempts use large perform across-facility resulted from lack conceptual framework guide analysis. propose which identifies component areas clarifies underlying assumptions analytic process. For each area, criteria are identified will maximize validity results. Hospitals as having unexpectedly high unfavorable when our applied be those where poor most likely found primary review process care.(ABSTRACT TRUNCATED AT 250 WORDS)