Toward the development of integrative risk-adjusted measures of quality using large clinical data bases. The case of anesthesia services.
This article describes a process to risk-adjust multiple outcomes of care and aggregate them into integrative measures of quality. A methodology is outlined for anesthesia services which is designed to use the new data base that is being constructed by the American Association for Nurse Anesthetists. Most of the methods should apply to other health professions as well, if outcomes of care and risk factors can be identified. The basic approach is to choose either exemplary or adverse outcomes of care which are under the control of the provider and to standardize these outcomes to take into consideration multiple risk factors.
Fleming
S T
ST
University of Missouri-Columbia 65211.
D000758:Anesthesia / Q000009:adverse effects* / Q000401:mortality / Q000592:standards; D000761:Anesthesia Department, Hospital / Q000592:standards*; D016208:Databases, Factual; D006801:Humans; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000592:standards; D012308:Risk Management / Q000379:methods*; D012956:Societies, Nursing; D014481:United States