we determine what conditions a patient has or procedures performed (for
example: total knee replacement) to identify patient like groups using ICD-9 and ICD-10 codes or in some cases DRGs. The model outcomes reflect
clinical-based measures of patient disposition during and after care and
include in-hospital complications, or in-hospital and 30-day post-admission
A full list of ICD-9 and
ICD-10 codes can be found in the Healthgrades ICD-10 Mapping
Next we consider the current condition of the patient and how that could possibly affect the outcome of the condition/procedure.
a. Develop list of potential risk factors (comorbid conditions, etc.)
b. Use logistic regression to determine which of the potential risk factors statistically relate to the outcome as well as the strength of that relationship
Then we determine the hospital's predicted outcome rate by summing the individual patient predicted values for each hospital.
Lastly, using a statistical test, we compare the actual outcome for each hospital with that same hospital's predicted outcome.
A star rating is then assigned based on whether the hospital performed statistically better than, the same as, or worse than the predicted outcome.