Murtaugh Christopher M, Peng Timothy, Aykan Hakan, Maduro Gil
Visiting Nurse Service of New York, Center for Home Care Policy and Research, New York 10001, USA.
Health Care Financ Rev. 2007 Spring;28(3):77-94.
Risk adjustment is a critical tool in public reporting of quality measures. Its aim is to level the playing field so that providers serving different patients can be meaningfully compared. We used a theory and evidence-based approach to develop risk-adjustment models for the 10 publicly reported home health quality measures and compared their performance with current models developed using a data-driven stepwise approach. Overall, the quality ratings for most agencies were similar regardless of approach. Theory and evidence-based models have the potential to simplify risk adjustment, and thereby improve provider and consumer understanding and confidence in public reporting.
风险调整是质量指标公开报告中的一项关键工具。其目的是营造公平竞争的环境，以便能够对为不同患者提供服务的医疗机构进行有意义的比较。我们采用了一种基于理论和证据的方法，为10项公开报告的家庭健康质量指标开发风险调整模型，并将其性能与使用数据驱动逐步法开发的现有模型进行比较。总体而言，无论采用何种方法，大多数机构的质量评级都相似。基于理论和证据的模型有可能简化风险调整，从而提高医疗机构和消费者对公开报告的理解和信心。
