Shortcomings of the Risk-Adjusted Mortality Rate
and its Application
(2002) showed that risk-adjusted mortality rates
at very low-volume hospitals (those averaging less than one pancreatic resection per year) were 12.5 percent higher than the rates at very high-volume hospitals (16.3 percent vs.
We used these 30-day risk-adjusted mortality rates
to rank hospitals (1 to 268).
(10) found a significant different crude 30-day mortality rates according to hospital PCI volume, but did not find a relationship between hospital volume and 30-day risk-adjusted mortality rates
following PCI in Korea.
We next examined the changes in risk-adjusted mortality rates
at the remaining open hospitals in Philadelphia county in 1997-1999 and the changes in delivery volume at these hospitals.
We used risk-adjustment software developed by Elixhauser to calculate risk-adjusted mortality rates
for all patients, as well as white and black patients separately, for each acute-care hospital (Elixhanser et al.
Specifically, we evaluated whether reliability adjustment improves the ability of risk-adjusted mortality rates
from an earlier time period (2003-2004) to predict risk-adjusted mortality in a subsequent time period (2005-2006).
We use condition-specific, risk-adjusted mortality rates
estimated by the IQI module of the AHRQ QI software because hospital-level variations among the IQI rates may be associated with differences in quality of care (Andrews, Russo, and Pancholi 2007).
Our objective in this study is to examine the association of process measures with observed differences in risk-adjusted mortality rates
and expected differences in risk-adjusted mortality rates
to test the hypothesis that performance on process measures not only directly improves patient outcomes, but is also a marker of unmeasured aspects of health care quality.
We then changed one variable at a time and recalculated the risk-adjusted mortality rate
to obtain the effect of each variable.
News & World Report that identified "America's Best Hospitals." For each hospital listed in the periodical the authors used APR-DRGs to develop a risk-adjusted mortality rate
that was used as one factor in determining a hospital's ranking.
But we could not find any relationship between hospital volume and 30-day risk-adjusted mortality rates
(1.3% in low, 1.0% in medium and 1.1% in high volume hospitals) following PCI in Korea (Table 4).