Hospital Quality Guide Methodology 2007 - 2008 4
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Pulmonary
The Pulmonary service area rating is based on:
·
Chronic obstructive pulmonary disease (COPD)
·
Pneumonia
We first calculate the average star ratings for these medical issues by evenly weighting the individual
mortality star ratings. For pneumonia we calculate inhospital mortality, inhospital +1 month mortality, and
inhospital +6 month mortality. For COPD we calculate in hospital mortality and +6 month mortality. The
Pulmonary service area rating is based on an average of the average star ratings. To receive a rating in this
service area, a hospital had to have star ratings for both medical issues based on MedPAR data.
Stroke
The Stroke service area rating is based on one medical issue: stroke. To receive a rating in this service
area, a hospital had to have a transfer-out rate of less than 10 percent in the most recent year used (2005
for all-payer, 2006 for Medicare). The Stroke service area rating is based on the average of inhospital
mortality, inhospital +1 month mortality, and inhospital +6 month mortality.
Vascular
The Vascular service area rating is based on:
·
Resection/replacement of abdominal aorta
·
Carotid surgery
·
Peripheral vascular bypass
We first calculate the overall star ratings for resection/replacement of abdominal aorta by averaging the
inhospital mortality, inhospital +1 month mortality, and inhospital +6 month mortality. The Vascular service
area rating is based on the average of the overall resection/replacement of abdominal aorta rating, plus
carotid surgery and peripheral vascular bypass. To receive a rating in this service area, a hospital had to
have star ratings for all three medical issues based on MedPAR data.
Medical Issues Rating Methodologies
HealthGrades rates hospitals using the following methodologies:
·
HealthGrades' proprietary risk-adjustment methodology
·
Programmatic evaluations (maternity care and women's health)
HealthGrades' Proprietary Risk-Adjustment Methodology
For 29 medical issues, the risk adjustment is based upon a proprietary HealthGrades methodology.
Developing ratings involved two steps. First, the predicted value for a specific outcome is estimated.
Second, the predicted outcome was compared to the actual outcome. HealthGrades further determines if
the difference between the predicted outcome and the actual outcome is statistically significant.
Risk adjustment is important because in health care, patients differ from one another with respect to their
health status, demographics, and type of procedure performed. Risk factors include gender, age, specific
procedure performed, and current health conditions such as hypertension, diabetes, and congestive heart
