Hospital Quality Guide Methodology 2006 7
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May not be reprinted or reproduced without permission from Health Grades, Inc.
While DRGs focus on the Medicare population, APR-DRGs describe a complete cross-section of acute care
patients and are specifically designed to adjust data for severity of illness (How sick is the patient?) and risk
of mortality (How likely is it that the patient will die?). The fundamental principle of APR-DRGs is that the
severity of illness and risk of mortality are both dependent on the patient's underlying condition. High
severity of illness and risk of mortality are characterized by multiple serious diseases and the interactions
between the disorders.
The 3M
TM
APR-DRG methodology is the most widely used severity-of-illness and risk-of-mortality adjustment
tool available today. It has become the standard for adjusting large volumes of data to account for
differences related to the individual's severity of illness or risk of mortality. As a result, the focus can be on
the differences in clinical care, thus providing equitable comparisons of quality and cost of care. APR-DRGs
are also recognized as the tool of choice by commissions, state agencies, and others who disseminate
comparative performance data to regulators, payers, and the general public.
How HealthGrades Rates Hospitals: Maternity Care
HealthGrades analyzes the following factors for each hospital:
·
Volume of vaginal and cesarean section (C-section) single live-born deliveries
·
Complication rate from vaginal and C-section single live-born deliveries
·
Complication rate for "patient choice" C-sections
·
Newborn mortality rate stratified into six birth weight and normal newborn categories
For each of the above factors except volume, hospitals are ranked separately based on whether or not they
have a newborn ICU. The presence of a newborn ICU is defined as being an intermediate or intensive care
unit for newborn care.
HealthGrades assigns a weight to each factor based on its importance to the quality of Maternity Care in the
hospital. The weights are determined through a survey of physicians. Each factor's score is multiplied by its
weight and then summed to create an overall score for each hospital.
Based upon each hospital's overall score, HealthGrades applies the following star ratings for Maternity
Care:
Best Top 15% of all hospitals within 17 states
As Expected Middle 70% of all hospitals within 17 states
Poor Bottom 15% of all hospitals within 17 states
