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  1. Variation in practice for discretionary admissions : impact on estimates of quality of hospital care.

    Article - En anglais

    Objective.-To demonstrate theoretically and empirically the existence of systematic bias in commonly reported standardized hospital mortality ratios when variation in hospital admission practice is not adjusted for in the analysis.

    The underlying analytic model used in hospital mortality analyses is specified and the confounding effect of selection bias arising from variation in admission practice is shown.

    Data Sources.-An empirical example is presented using state-level data from the Health Care Financing Administration's Medicare Hospital Information Report for 1988 to 1990.

    Study Selection.-The Medicare Hospital Information data are used to demonstrate the effects of the bias because they contain population-based admission rates and mortality rates.

    Mots-clés Pascal : Mortalité, Milieu hospitalier, Biais méthodologique, Admission hôpital, Homme, Rapport standardisé mortalité, Etats Unis, Amérique du Nord, Amérique, Etude statistique, Epidémiologie

    Mots-clés Pascal anglais : Mortality, Hospital environment, Methodological bias, Hospital admission, Human, Standardized mortality ratio, United States, North America, America, Statistical study, Epidemiology

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 94-0431135

    Code Inist : 002B28F. Création : 199406.