Rethinking Measures and Mortality Attribution in Health Care: The ENT Example.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-01 Epub Date: 2024-10-13 DOI:10.1002/ohn.1015

Samip Patel, Lorenzo Olivero, Jorge Sinclair De Frias, Stephanie S Anderson, Ben D Pollock, Marian D Lee, Razvan M Chirila, Hemant S Murthy, Pramod K Guru, Richard Taylor, Pablo Moreno Franco, Terri Menser

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引用次数: 0

Abstract

National performance metrics ultimately enhance patient decision-making and promote meaningful improvements in health care delivery, which makes having valid and reliable measures essential. This study examined US News and World Report metrics from 2019 to 2012 and used electronic health record data, combined with detailed chart review across 3 in-system hospitals, to assess the provision of care compared to the attribution of patients assigned to the ear, nose, and throat (ENT) mortality group. Of the initial 47 ENT-attributed deaths, 23 of those were verified, dimensioning the mortality rate from 1.7% to just 0.8%. These results underscore the necessity of rethinking measures and mortality attribution methodologies to be more accurate. Current methods use Medicare Severity Diagnosis Related Group billing coding to map the attribution. We suggest transitioning away from specialty ranking approaches and towards a procedure and condition "rating" approach to ensure that these ranking types capture data about the provision of care within a given encounter.

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重新思考医疗保健中的措施和死亡率归因：以 ENT 为例。

国家绩效指标最终会增强患者的决策能力，促进医疗服务的切实改善，因此，有效、可靠的指标至关重要。这项研究检查了《美国新闻与世界报道》从 2019 年到 2012 年的指标，并使用电子健康记录数据，结合 3 家系统内医院的详细病历审查，评估了与耳鼻喉科（ENT）死亡率组患者归因相比的医疗服务提供情况。在最初归因于耳鼻喉科的 47 例死亡病例中，有 23 例得到核实，死亡率从 1.7% 降至 0.8%。这些结果突出表明，有必要重新思考措施和死亡率归因方法，使其更加准确。目前的方法使用医疗保险严重程度诊断相关组账单编码来绘制归因图。我们建议放弃专科排名方法，转而采用程序和条件 "评级 "方法，以确保这些排名类型能捕捉到在特定情况下提供护理的数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.