Top Things to Know: Risk Adjustment of Ischemic Stroke Outcomes for Comparing Hospital Performance
Published: January 23, 2014
- This statement addresses statistical considerations for the evaluation of hospital outcomes in persons with stroke.
- Several variables are addressed in this statement for possible 30-day outcome measures.
- The three key outcome measures addressed are as follows:
- functional outcomes,
- mortality, and
- 30-day readmission.
- Several variables that should be included in a risk adjustment model include age, gender, stroke severity, comorbid conditions, vascular risk factors, and pre-stroke function.
- Evidence shows that stroke severity is the most important prognostic factor as it relates to stroke outcome for stroke patients.
- Stroke severity may be the most important factor in addressing hospital level performance for 30-day stroke mortality.
- Risk adjustment models should include some way to measure stroke severity.
- There should be some type of standardized model used at all hospitals caring for stroke patients.
- The reliability and accuracy of a standardized model should be the same across all facilities.
- It is important to consider all of the methodological issues that accompany developing risk adjustment models for development of any type measure for assessing hospital care of the stroke patient.
Citation
Katzan IL, et al; on behalf of the American Heart Association Stroke Council, Council on Quality of Care and Outcomes Research, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular Surgery and Anesthesia, and Council on Clinical Cardiology. Risk adjustment of ischemic stroke outcomes for comparing hospital performance: a statement for healthcare professionals from the American Heart Association/American Stroke Association [published online ahead of print January 23, 2014]. Stroke. doi: 10.1161/01.str.0000441948.35804.77.