ArticleAmerican journal of medical quality : the official journal of the American College of Medical Quality
Problematic Risk Adjustment in National Healthcare Safety Network Measures.
Article in American journal of medical quality : the official journal of the American College of Medical Quality. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
- Applying the standardized infection ratio for reporting surgical site infections in Australian healthcare facilities.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Improving Quality Measurement: Design Principles for Quality Measures.The Journal of ambulatory care managementArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
This article reviews the risk-adjustment models underpinning the National Healthcare Safety Network (NHSN) standardized infection ratios. After first describing the models, the authors focus on hospital intensive care unit (ICU) designation as a variable employed across the various risk models. The risk-adjusted frequency with which ICU services are reported in Medicare fee-for-service claims data was compared as a proxy for determining whether reporting of ICU days is similar across hospitals. Extreme variation was found in the reporting of ICU utilization among admissions for congestive heart failure, ranging from 25% in the lowest admission hospital quartile to 95% in the highest. The across-hospital variation in reported ICU utilization was found to be unrelated to patient severity. Given that such extreme variation appears in a designation of ICU versus non-ICU utilization, the NHSN risk-adjustment models' dependence on nursing unit designation should be a cause for concern.
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Registered trials
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