Evaluating hospital performance based on excess cause-specific incidence

Stat Med. 2015 Apr 15;34(8):1334-50. doi: 10.1002/sim.6409. Epub 2015 Jan 15.

Abstract

Formal evaluation of hospital performance in specific types of care is becoming an indispensable tool for quality assurance in the health care system. When the prime concern lies in reducing the risk of a cause-specific event, we propose to evaluate performance in terms of an average excess cumulative incidence, referring to the center's observed patient mix. Its intuitive interpretation helps give meaning to the evaluation results and facilitates the determination of important benchmarks for hospital performance. We apply it to the evaluation of cerebrovascular deaths after stroke in Swedish stroke centers, using data from Riksstroke, the Swedish stroke registry.

Keywords: competing risks; excess cumulative incidence; hospital performance evaluation; quality-of-care; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Benchmarking / standards
  • Benchmarking / statistics & numerical data
  • Cause of Death
  • Clinical Audit / methods
  • Clinical Audit / standards*
  • Data Interpretation, Statistical
  • Hospital Mortality*
  • Hospitals / standards*
  • Hospitals / statistics & numerical data
  • Humans
  • Incidence
  • Logistic Models
  • Proportional Hazards Models
  • Quality Assurance, Health Care / methods
  • Quality Assurance, Health Care / standards*
  • Registries / statistics & numerical data
  • Risk Adjustment / methods
  • Risk Adjustment / standards
  • Stroke / mortality*
  • Sweden / epidemiology