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2021, Number 3

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Rev Acta Médica 2021; 22 (3)

Evaluation of three risk adjustment procedures for hospital stay as a performance indicator

Tamargo BTO, Quesada PS, Gutiérrez RÁR, López LN

Language: Spanish
References: 27
Page:
PDF size: 204.54 Kb.


ABSTRACT

Introduction: The hospital stay is the indicator par excellence of the efficiency of the services provided. However, it is well known that its changes are not only subject to efficiency problems, but also to the characteristics of the patients, which constitute the resource for its calculation.
Objective: To evaluate three risk adjustment procedures for hospital stay as a performance indicator.
Methods: Retrospective research in the Internal Medicine service at Hermanos Ameijeiras Clinical Surgical Hospital in 2019 first semester. Five hundred thirty four (534) medical records of living Cuban patients were included. The capacity of each procedure to detect inefficiencies in hospital care was evaluated through the analysis of variance and the construction of ROC curves.
Results: There were significant differences between the three areas under the ROC curves. For the procedure that uses the Severity Index of Clinical Services of Hermanos Ameijeiras Hospital, the result was 0.800 (p <0.001) (95% CI 0.749 - 0.851). For the Related Diagnosis Groups, the area under the ROC curve was 0.738 (p <0.001) (95% CI 0.680 - 0.796). In the case of multiple linear regression, the area under the ROC curve was 0.747 (p <0.001) (95% CI 0.690 - 0.805).
Conclusions: The risk adjustment procedure that estimates the expected stay from the severity index was the most effective for detecting efficiency problems. Its use is recommended because its simplest calculation.


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