AN INTEGER PROGRAMMING-MODEL TO LIMIT HOSPITAL SELECTION IN STUDIES WITH REPEATED SAMPLING

Objective. We describe an integer programming model that, for studies requiring repeated sampling from hospitals, can aid in selecting a lim ited set of hospitals from which medical records are reviewed. Study S etting. The model is illustrated in the context of two studies: (1) an analysis of the relationship between variations in hospital admission rates across geographic areas and rates of inappropriate admissions; and (2) a validation of computerized algorithms that screen for compli cations of hospital care. Study Design. Common characteristics of the two studies: (1) hospitals are classified into categories, e.g., high, medium, and low; (2) the classification process is repeated several t imes, e.g., for different medical conditions; (3) medical records are selected separately for each iteration of the classification; and (4) for budgetary and logistical reasons, reviews must be concentrated in a relatively small subset of hospitals. Data Collection/Extraction Met hods. In each study, hospitals are ranked based on analysis of hospita l discharge abstract data. Conclusion. The model is useful for identif ying a subset of hospitals at which more intensive reviews will be con ducted.