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Performance Characteristics of Profiling Methods and the Impact of Inadequate Case-mix Adjustment.

Yanjun ChenDamla ŞentürkJason P EstesLuis F CamposConnie M RheeLorien S DalrympleKamyar Kalantar-ZadehDanh V Nguyen
Published in: Communications in statistics: Simulation and computation (2019)
Profiling or evaluation of health care providers involves the application of statistical models to compare each provider's performance with respect to a patient outcome, such as unplanned 30-day hospital readmission, adjusted for patient case-mix characteristics. The nationally adopted method is based on random effects (RE) hierarchical logistic regression models. Although RE models are sensible for modeling hierarchical data, novel high dimensional fixed effects (FE) models have been proposed which may be well-suited for the objective of identifying sub-standard performance. However, there are limited comparative studies. Thus, we examine their relative performance, including the impact of inadequate case-mix adjustment.
Keyphrases
  • healthcare
  • case report
  • primary care
  • single cell
  • machine learning
  • big data
  • social media