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The Value of Clinical Risk Adjustment
Two recent peer reviewed journal articles highlight the value
of using clinical data in risk adjustment methodologies, in particular
the use of objective laboratory results. These articles also identify
the potential for misclassification of hospital performance rankings
when the risk adjustment methodology uses only administrative data.
The first, published in The American Surgeon, entitled “The
Hazards of Using Administrative Data to Measure Surgical Quality,”
reviews data used in risk adjusting outcomes. They concluded: “These
illustrations demonstrate sub-optimal risk stratification with
administrative claims data only, but show that present-on-admission
coding combined with readily available laboratory data and
vital signs can support accurate risk-adjustment for the
assessment of surgical outcomes.1
“Enhancement of Claims Data to Improve Risk Adjustment
of Hospital Mortality”, published in JAMA, is
the second article. Their conclusion: This study supports the value
of adding present on admission codes and numerical laboratory
values to administrative databases.2
MediQual™ is pleased to provide clinical risk adjustment in its
products and services to support the measurement and improvement
of acute care outcomes. For more information, contact our Professional
Services team at 800.350.6444 or email: support@mediqual.com.
References:
1 Donald E. Fry, M.D., F.A.C.S., Michael B. Pine, M.D.,
M.B.A., Harmon S. Jordan, Sc.D., David C. Hoaglin, Ph.D., Barbara
Jones, M.A., Roger Meimban, Ph.D., “The Hazards
of Using Administrative Data to Measure Surgical Quality,"
Am Surg. 2006;72(11) 1031-7
2 Michael Pine, MD, MBA, Harmon S. Jordan, ScD, Anne
Elixhauser, PhD, Donald E. Fry, MD, David C. Hoaglin, PhD, Barbara
Jones, MA, Roger Meimban, PhD, David Warner, MS, Junius Gonzales,
MD, MBA. “Enhancement of Claims Data to Improve
Risk Adjustment of Hospital Mortality,” JAMA
2007;297:71-76 |
