Evidence map›Paper›PMID 26987446›Full record

ArticleHealth services research2016

Improving Medicare's Hospital Compare Mortality Model.

Jeffrey H Silber, Ville A Satopää, Nabanita Mukherjee, Veronika Rockova, Wei Wang, Alexander S Hill, Orit Even-Shoshan, Paul R Rosenbaum, Edward I George

Open access · bronzeAbstract read
In one paragraph

Article in Health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
13.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 30 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Jeffrey H SilberCenter for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA.
Ville A SatopääDepartment of Statistics, The Wharton School, The University of Pennsylvania, Philadelphia, PA.
Nabanita MukherjeeCenter for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA.
Veronika RockovaDepartment of Statistics, The Wharton School, The University of Pennsylvania, Philadelphia, PA.
Wei WangCenter for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA.
Alexander S HillCenter for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA.
Orit Even-ShoshanCenter for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA.
Paul R RosenbaumThe Leonard Davis Institute of Health Economics, The University of Pennsylvania, Philadelphia, PA.
Edward I GeorgeDepartment of Statistics, The Wharton School, The University of Pennsylvania, Philadelphia, PA.
University of Pennsylvania · USChildren's Hospital of Philadelphia · US

Funding

Improving the Framework for Healthcare Public ReportingR21HS021854 · AHRQ · CHILDREN'S HOSP OF PHILADELPHIA · PI SILBER, JEFFREY H · 2012 to 2014
$871k
AHRQ HHS R21-HS021854
6 · The paper itself

Abstract

objectiveTo improve the predictions provided by Medicare's Hospital Compare (HC) to facilitate better informed decisions regarding hospital choice by the public. DATA SOURCES/

settingMedicare claims on all patients admitted for Acute Myocardial Infarction between 2009 through 2011. STUDY

designCohort analysis using a Bayesian approach, comparing the present assumptions of HC (using a constant mean and constant variance for all hospital random effects), versus an expanded model that allows for the inclusion of hospital characteristics to permit the data to determine whether they vary with attributes of hospitals, such as volume, capabilities, and staffing. Hospital predictions are then created using directly standardized estimates to facilitate comparisons between hospitals. DATA COLLECTION/EXTRACTION

methodsMedicare fee-for-service claims. PRINCIPAL

findingsOur model that included hospital characteristics produces very different predictions from the current HC model, with higher predicted mortality rates at hospitals with lower volume and worse characteristics. Using Chicago as an example, the expanded model would advise patients against seeking treatment at the smallest hospitals with worse technology and staffing.

conclusionTo aid patients when selecting between hospitals, the Centers for Medicare and Medicaid Services (CMS) should improve the HC model by permitting its predictions to vary systematically with hospital attributes such as volume, capabilities, and staffing.

Indexed as

Hospital MortalityAgedBayes TheoremCohort StudiesFee-for-Service PlansHealth Services ResearchHospitalsHumansMedicareModels, StatisticalMyocardial InfarctionUnited Statesacute myocardial infarctionBayesian statisticshospital compareMedicare quality of care

Identifiers

PMID26987446
PMCPMC4874942
OpenAlexW2299778661

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.