BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) publicly reports hospital-specific risk-standardized, 30-day, all-cause, mortality rates (RSMRs) for all hospitalizations among fee-for-service Medicare beneficiaries for acute myocardial infarction (AMI), heart failure (HF), and pneumonia at non-Federal hospitals. OBJECTIVE: To examine the performance of the statistical models used by CMS among veterans at least 65 years of age hospitalized for AMI, HF, and pneumonia in Veterans Health Administration (VHA) hospitals. RESEARCH DESIGN: Cross-sectional analysis of VHA administrative claims data between October 1, 2006 and September 30, 2009. SUBJECTS: Thirteen thousand forty-six veterans hospitalized for AMI among 123 VHA hospitals; 26,379 veterans hospitalized for HF among 124 VHA hospitals; and 31,126 veterans hospitalized for pneumonia among 124 VHA hospitals. MEASURES: Hospital-specific RSMR for AMI, HF, and pneumonia hospitalizations calculated using hierarchical generalized linear models. RESULTS: Median number of AMI hospitalizations per VHA hospital was 87. Average AMI RSMR was 14.3% [95% confidence interval (CI), 13.9%-14.6%] with modest heterogeneity among VHA hospitals (RSMR range: 8.4%-20.3%). The c-statistic for the AMI RSMR statistical model was 0.79. Median number of HF hospitalizations was 188. Average HF RSMR was 10.1% (95% CI, 9.9%-10.4%) with modest heterogeneity (RSMR range: 6.1%-14.9%). The c-statistic for the HF RSMR statistical model was 0.73. Median number of pneumonia hospitalizations was 221.5. Average pneumonia RSMR was 13.0% (95% CI, 12.7%-13.3%) with modest heterogeneity (RSMR range: 9.0%-18.4%). The c-statistic for the pneumonia RSMR statistical model was 0.72. CONCLUSIONS: The statistical models used by CMS to estimate RSMRs for AMI, HF, and pneumonia hospitalizations at non-Federal hospitals demonstrate similar discrimination when applied to VHA hospitals.
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) publicly reports hospital-specific risk-standardized, 30-day, all-cause, mortality rates (RSMRs) for all hospitalizations among fee-for-service Medicare beneficiaries for acute myocardial infarction (AMI), heart failure (HF), and pneumonia at non-Federal hospitals. OBJECTIVE: To examine the performance of the statistical models used by CMS among veterans at least 65 years of age hospitalized for AMI, HF, and pneumonia in Veterans Health Administration (VHA) hospitals. RESEARCH DESIGN: Cross-sectional analysis of VHA administrative claims data between October 1, 2006 and September 30, 2009. SUBJECTS: Thirteen thousand forty-six veterans hospitalized for AMI among 123 VHA hospitals; 26,379 veterans hospitalized for HF among 124 VHA hospitals; and 31,126 veterans hospitalized for pneumonia among 124 VHA hospitals. MEASURES: Hospital-specific RSMR for AMI, HF, and pneumonia hospitalizations calculated using hierarchical generalized linear models. RESULTS: Median number of AMI hospitalizations per VHA hospital was 87. Average AMI RSMR was 14.3% [95% confidence interval (CI), 13.9%-14.6%] with modest heterogeneity among VHA hospitals (RSMR range: 8.4%-20.3%). The c-statistic for the AMI RSMR statistical model was 0.79. Median number of HF hospitalizations was 188. Average HF RSMR was 10.1% (95% CI, 9.9%-10.4%) with modest heterogeneity (RSMR range: 6.1%-14.9%). The c-statistic for the HF RSMR statistical model was 0.73. Median number of pneumonia hospitalizations was 221.5. Average pneumonia RSMR was 13.0% (95% CI, 12.7%-13.3%) with modest heterogeneity (RSMR range: 9.0%-18.4%). The c-statistic for the pneumonia RSMR statistical model was 0.72. CONCLUSIONS: The statistical models used by CMS to estimate RSMRs for AMI, HF, and pneumonia hospitalizations at non-Federal hospitals demonstrate similar discrimination when applied to VHA hospitals.
Authors: Bradley N Doebbeling; Thomas E Vaughn; Robert F Woolson; Paul M Peloso; Marcia M Ward; Elena Letuchy; Bonnie J BootsMiller; Toni Tripp-Reimer; Laurence G Branch Journal: Med Care Date: 2002-06 Impact factor: 2.983
Authors: Carol M Ashton; Julianne Souchek; Nancy J Petersen; Terri J Menke; Tracie C Collins; Kenneth W Kizer; Steven M Wright; Nelda P Wray Journal: N Engl J Med Date: 2003-10-23 Impact factor: 91.245
Authors: Marta L Render; James Deddens; Ron Freyberg; Peter Almenoff; Alfred F Connors; Douglas Wagner; Timothy P Hofer Journal: Crit Care Med Date: 2008-04 Impact factor: 7.598
Authors: J Daley; M G Forbes; G J Young; M P Charns; J O Gibbs; K Hur; W Henderson; S F Khuri Journal: J Am Coll Surg Date: 1997-10 Impact factor: 6.113
Authors: Gregory C Pope; John Kautter; Randall P Ellis; Arlene S Ash; John Z Ayanian; Lisa I Lezzoni; Melvin J Ingber; Jesse M Levy; John Robst Journal: Health Care Financ Rev Date: 2004
Authors: Sudhakar V Nuti; Li Qin; John S Rumsfeld; Joseph S Ross; Frederick A Masoudi; Sharon-Lise T Normand; Karthik Murugiah; Susannah M Bernheim; Lisa G Suter; Harlan M Krumholz Journal: JAMA Date: 2016-02-09 Impact factor: 56.272
Authors: Linda Calvillo-King; Danielle Arnold; Kathryn J Eubank; Matthew Lo; Pete Yunyongying; Heather Stieglitz; Ethan A Halm Journal: J Gen Intern Med Date: 2012-10-06 Impact factor: 5.128
Authors: Amal N Trivedi; Lan Jiang; Gabriella Silva; Wen-Chih Wu; Vincent Mor; Michael J Fine; Nancy R Kressin; Roee Gutman Journal: JAMA Netw Open Date: 2020-12-01