Measurement of Severity from Claims Data

Measurement of Severity from Claims Data

Measurement of Severity from Claims Data FA R R O K H A L E M I , P H . D . In Case of Poor Outcomes First blame patients illness Then examine patients preferences Last attribute it to poor quality Not Accurate Enough 319,740 articles in PubMed Maybe insufficient Large data make it worst Example of Lack of Accuracy Severity of MI explains 76% of outcomes of

care Severity of Single Diagnosis Case 1 2 3 4 5 6 7 8 9 10 1st 2nd 3rd

4th Diagnosis Diagnosis Diagnosis Diagnosis MI CHF MI MI CHF Diabetes MI CHF CHF Diabetes MI Hypertension ACL surgery MI Diabetes CHF

Hypertension MI Alcohol use CHF 5th Diagnosis Alcohol use Length of stay 5 2 6 7 4 2 1

6 3 3 Severity of Single Diagnosis Case 1 2 3 4 5 6 8 9 10 MI 1

1 1 1 0 1 1 1 0 CHF 1 0 1 1 1 0 1 0 1

Alcohol Hypertensio Diabetes use n 0 0 0 0 0 0 1 0 0 0 0 0 1 0

0 0 0 1 1 1 1 0 1 0 0 0 0 Length of stay 5 2 6

7 4 2 6 3 3 Severity of Single Diagnosis Coefficients Intercept MI CHF Diabetes Alcohol use Hypertension 0 2.38 3.40

0.33 0.49 -0.50 Severity of Single Diagnosis Coefficients Intercept MI CHF Diabetes Alcohol use Hypertension 0 2.38 3.40 0.33 0.49

-0.50 Standardized score 0.74 1.00 0.22 0.26 0.00 Severity of Multiple Diagnoses Severity of Multiple Diagnoses Overall severity = 1 - (1 - 0.22) (1 - 0.26) = 0.42 Accuracy Alemi and Walters

Typic al New A simple Procedure for More Accurate Measurement of Severity TA K E H O M E L E S S O N

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