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Health Services Research & Development

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HERC Health Economics Seminar

Hospital Profiling with Enhanced Risk Adjustment Based on Laboratory Tests and Vital Signs Data

by Ann Borzecki, MD, MPH ; Amresh Hanchate, Ph.D.
Seminar date: 2/19/2014

Description: Improving risk adjustment improves the ability to compare patient outcomes across providers and isolate potential quality differences. With readily-available automated data on laboratory tests and vital signs, the VA is uniquely equipped to improve risk adjustment of current hospital profiling methods, including VA Hospital Compare, that rely on diagnostic and procedure codes from administrative data. This presentation will cover findings from a HSR&D-funded study that extends the recent literature on the impact of enhanced risk adjustment on hospital profiles. Specifically, by augmenting the VA Hospital Compare models with data on laboratory tests and vital signs, the presentation will focus on two issues: a) metrics to quantify this impact, and b) assessing sensitivity of the impact to the choice of profiling method. We will report findings using 30-day mortality outcomes for Veterans hospitalized in VA hospitals for acute myocardial infarction, heart failure and pneumonia. Target audience: Researchers, clinicians, management leadership and policymakers interested in outcomes evaluation.

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