This may be caused by a reduction in data points, or that thedifferences in risk characteristics of the various DRGs within most MDCscoincide with a metropolitan-rural divide
This is glorious!
11 Matching Annotations
- Aug 2015
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Quality (DRG) 1.2675 0.61
It seems there is no statistically significant differences in the Quality measured between the two aggregation levels.
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total offive variables in the frontierestimate: three input types in dollars, output in number of patient-days, andquality in estimated HSMR values.
So this is the model translated as:
number of patient-days(by hospital*) = HSMR value(ratio) + capital prices($) + labor($) + materials($)
- all the co-variants are also accounted by Hospital
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Chun Lok K. Li
Unknown to me!
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Hospital quality and, in some cases, its relationship with effi-ciency differs depending on aggregations.
They are talking about diagnosis (procedures) //activity// aggregation.
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bootstrap-adjustedTobit regression as specified by Simar and Wilson (2007
*interesting reference! on "bootstrap-adjusted Tobit regression!
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deterministic
Is appropriate the use of a deterministic model here? It seems to me that it will be less accurate than a probabilistic one, and that that could influence the results of the comparison of the different aggregation levels biasing the conclusions.
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quality-adjusted frontier analysis are available inEckermann and Coelli (2013).
*Interesting reference for reviewing!
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Details of the estimationprocess can be found in operations research textbooks (e.g., Banker, Charnes,and Cooper 1984; Ramanathran and Ramanathan 2003)
*Interesting reference for reviewing!
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main weakness of HSMR
There are many others as mentioned in the previous literature references.
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The Hospital Standardized Mortality Ratio (HSMR)
Commenting on the fallacy of the HSMR as a 'quality measure' Med Care. 2012 Aug;50(8):662-7. doi: 10.1097/MLR.0b013e31824ebd9f. The hospital standardized mortality ratio fallacy: a narrative review. van Gestel YR1, Lemmens VE, Lingsma HF, de Hingh IH, Rutten HJ, Coebergh JW.
The death of death rates? BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3466 (Published 14 July 2015) Cite this as: BMJ 2015;351:h3466 By Tim Doran, Karen Bloor, and Alan Maynard
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