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Invited Critique
Feb 2012

How Should We Risk-Adjust Hospital Outcome Comparisons?Comment on “Predicting In-Hospital Mortality in Patients Undergoing Complex Gastrointestinal Surgery”

Arch Surg. 2012;147(2):135-136. doi:10.1001/archsurg.2011.1846

The need for reliable measures of surgical quality is at an all-time high. Most experts agree the best way to assess surgical quality is to directly measure the outcomes of care. However, to compare outcomes across hospitals, differences in patient risk must be adequately accounted for. Selecting appropriate risk adjustment models is of crucial importance. Otherwise, hospitals and surgeons will not be fairly judged. In this study, Grendar and colleagues1 compare several different risk adjustment models for use with administrative data. These models rely on using secondary billing codes to identify factors (eg, coexisting diseases) associated with adverse outcomes.

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