Systems for comparing actual and predicted mortality rates: characteristics to promote cooperation in improving hospital care
Article Abstract:
Hospital mortality rates have been used to compare the quality of care at different hospitals since the 1980s. Actual and expected hospital mortality rates for Medicare patients have been released by the federal government every year since 1986. These statistics often do not adjust for differences in the severity of illness between different patient groups. The Acute Physiologic, Age, Chronic Health Evaluation (APACHE) is a mortality predictor that adjusts for differences in illness severity. A research study found that APACHE III may be an effective method for evaluating the quality of care at different hospitals. Mortality rates may be an effective method for comparing quality of care because they provide a objective endpoint. Criteria have been developed for evaluating the effectiveness of different types of mortality rates. APACHE III satisfies approximately half of these criteria.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1993
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Capitated payment for medical care and the role of the physician
Article Abstract:
Doctors need to take an active role in encouraging cost-effectiveness in the health care market without undermining patient trust that doctors will provide quality care. A researcher highlighted the effects that financial incentives to withhold treatment have on patient trust and suggested roles for doctors to play in the evolving managed care market. One study has shown that financial incentives to withhold healthcare reduce the number of both necessary and unnecessary treatments. Four of five randomly polled patients indicated significant dissatisfaction with doctors receiving financial incentives for withholding care. Regulations that involve review by the public and health professionals may be the best short-term solution to controlling cost and assuring quality care.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1996
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Predictions of hospital mortality rates: a comparison of data sources
Article Abstract:
A combination of typical medical record data and laboratory findings appear to provide accurate death rate predictions. Researchers compared the accuracy of death rate estimates using medical record data alone, medical record data plus laboratory findings, and a combination of medical record data, laboratory findings, and patient and condition specific data. They used records from 46,769 patients at 30 hospitals. Calculations based on laboratory findings accurately predicted 95% of the patient deaths. Medical records and laboratory data sets are readily available and easily merged electronically.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1997
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