JUDGING HOSPITALS BY SEVERITY-ADJUSTED MORTALITY-RATES - THE CASE OF CABG SURGERY

In many health care marketplaces, outcomes assessment is central to mo nitoring quality while controlling costs. Comparing outcomes across pr oviders generally requires adjustment for patient severity. For mortal ity rates and other adverse outcomes comparisons, severity adjustment ideally aims to control for patient characteristics prior to the healt h care intervention. A variety of severity methodologies, specifically for hospitalized patients, are commercially available, Some have been adopted by state or regional initiatives for publicly comparing hospi tal outcomes, We applied 14 common severity measures to the same data set to determine whether judgments about risk-adjusted hospital death rates are sensitive to the specific severity method. We examined 7,765 patients undergoing coronary artery bypass graft (CABG) surgery at 38 hospitals, Unadjusted death rates ranged from 0% to 11.2% across hosp itals, Comparisons of relative hospital performance were relatively in sensitive to the severity adjustment method.