DesHarnais S I, Chesney J D, Wroblewski R T, Fleming S T, McMahon L F
Research Department, Commission on Professional and Hospital Activities, Ann Arbor, Michigan.
Med Care. 1988 Dec;26(12):1129-48. doi: 10.1097/00005650-198812000-00004.
The Commission on Professional and Hospital Activities (CPHA) developed the Risk-Adjusted Mortality Index (RAMI), a method for comparing hospital death rates using existing abstract or billing data. The method is comprehensive insofar as it includes all payers and all types of cases except neonates. RAMI was designed to differentiate among admissions on the basis of the patient characteristics that increase or reduce the risk of dying in the hospital. Using a large national data base, risk factors were determined empirically within each of 310 clusters based on diagnosis-related groups (DRGs). The model was very effective at predicting risk-adjusted outcomes, with a correlation of 0.98 between actual and predicted deaths in a sample of 300 hospitals. RAMI appears to be a powerful tool for using existing data to monitor changes over time in hospital death rates.
专业医院活动委员会（CPHA）开发了风险调整死亡率指数（RAMI），这是一种利用现有摘要或计费数据比较医院死亡率的方法。该方法具有全面性，因为它涵盖了所有支付方以及除新生儿外的所有类型病例。RAMI旨在根据增加或降低医院死亡风险的患者特征对入院病例进行区分。利用一个大型国家数据库，基于诊断相关分组（DRG）在310个集群中的每一个集群内通过实证确定了风险因素。该模型在预测风险调整结果方面非常有效，在300家医院的样本中，实际死亡与预测死亡之间的相关性为0.98。RAMI似乎是利用现有数据监测医院死亡率随时间变化的有力工具。
