1. Are medical record front page data suitable for risk adjustment in hospital performance measurement? Development and validation of a risk model of in-hospital mortality after acute myocardial infarction
- Author
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Chao Zhang, Lin Li, Yan Liu, Bin Li, Jun Wang, Wei Liu, Xiang Li, Qi Zhang, Xueke Bai, Qianying Wang, Xi Li, Jing Zhang, Hui Zhang, Xin Li, Ying Wang, Min Zhang, Zhong Li, Lili Sun, Yuzhen Zhang, Qian Wang, Hong Wang, Wei Zhang, Lei Wu, Kai Li, Bo Yu, Hui Dai, Tianyu Liu, Guang Ma, Xiaoping Gao, Jie Wu, Shu Zhang, Junli Wang, Yan Han, Yong Wang, Guiling Li, Yang Cao, Yi Tian, Zheng Wan, Yin Zhou, Yun Chen, Jian Liu, Xin Jin, Jian Guan, Yu Huang, Feng Sun, Ruijun Zhang, Wei Luo, Qin Xu, Lei Shi, Xuexin Li, Weiwei Zhou, Long Chen, Wei Guo, Min Feng, Weimin Li, Qing Huang, Mei Chen, Yong Yi, Bin Xu, Yongfei Wang, Zhenqiu Lin, Jia Li, Chun Yuan, Ping Yang, Haifeng Wang, Zhiming Li, Kaihong Chen, Guangming Yang, Chun Wu, Liang Lu, Yong Gao, Hongyan Li, Xiaofei Li, Hua Lu, Yanlong Liu, Yuhong Liu, Ting Jiang, Yuhui Lin, Chaoqun Wu, Danwei Zhang, Tiannan Zhou, Guangda He, Shiping Weng, Shuying Xie, Lirong Wu, Jiulin Chen, Tianfa Li, Qin Yu, Shiguo Hao, Xuemei Wu, Yachen Zhang, Zhifeng Liu, Zhongxin Wang, Hao Jia, Bayin Bate, Badeng Qiqige, Xiang Jin, Ting Cai, Fengqin Liu, Dayong Xu, Xuejin He, Shui Yang, Jiping Wang, Lihua Gu, Shijiao Chen, Yongchao Zhi, Shengcheng Zhou, Lingjiao Jin, Yong Leng, Liangchuan Zhang, Tianyun Deng, Yuanjin Wang, Wenhua Zhang, Xinmin Ma, Xuan Ge, Xiaoping Wu, Yanming He, Fanju Meng, Dexi Liao, Guangyong Liu, Wen Qin, Wen Long, Xiangwen Chen, Baohong Zhang, Yonghou Yin, Bin Tian, Chaoyong Wu, Baoqi Liu, Zhihui Zhao, Haiming Li, Yansong Guo, Xinjing Chen, Liquan Xiang, Lin Ning, Xiuqi Li, Xing’an Wu, Congjun Tan, Mingfang Feng, Meili Wang, Liangfa Wen, Xiang Fu, Qunxing Xie, Yanni Zhuang, Jiaqian Lu, Qiuling Hu, Chunhui Xiao, Xiaoli Hu, Yongshuan Wu, Qiuli Wang, Youlin Xu, Xuefei Yu, Jianhong Zhang, You Zhang, Wentang Niu, Xiaolei Ma, Xiaowen Pan, Lifu Miao, Yanping Yin, Zhiying Zhang, Shutang Feng, Aiping Wang, Jiangli Zhang, Feipeng Li, Lijun Yu, Xinxin Zhao, Yuansheng Shen, Lizhen He, Zhiyi Rong, Xueqiao Wang, Rongjun Wan, Jianglin Tang, Guanghan Wu, Xiaohe Wu, Sang Ge, Pian Pu, Pingcuo Duoji, Yuming Du, Jianping Shi, Peihua Zhao, Jingsheng Sun, Hongxiang Li, Wen Liang, Zhiwen Dong, Zhenhai Zhao, Yaofeng Yuan, Zhirong Li, Jinbo Gao, Qiu’e Guo, Ruiqing Zhao, Guangjun Song, Lize Wang, Haiyun Song, Jinwen He, Jinming He, Keyong Shang, Changjiang Liu, Kuituan Xi, Rihui Liu, Peng Guo, Chaoyang Guo, Xiangjun Liu, Rujun Zhao, Zeyong Yu, Wenzhou Li, Xudong Jing, Huanling Wang, Xiyuan Zhao, Meifa Wei, Shengde Chen, Yong Fang, Ying Liao, Suzhe Cheng, Yunke Zhou, Xiaoxia Niu, Huifang Cao, Zebin Feng, Feilong Duan, Haiming Yi, Yuanxun Xu, Anran Guo, Xianshun Zhou, Hongzhuan Cai, Peng Zheng, Gaofeng Guo, Minwu Bao, Shaoliang Chen, Haibo Jia, Hongjuan Peng, Duanping Dai, Shaoxiong Hong, Song Chen, Dongya Zhang, Yudong Li, Jianbu Gao, Shouzhong Yang, Junhu An, Chenyang Shen, Yunfeng Liu, Huan Qu, Saiyong Chen, Dehai Jiao, Manhong Wang, Qiu Wang, Yingliang Xue, Cheng Yuan, Jianqing Zhang, Chunmei Wei, Yanmei Shen, Hehua Zhang, Hongmei Pan, Xiaowen Ma, Yanli Liang, Tianbiao Wang, Daguo Zhao, Xiaoming Tu, Zhenyan Gao, Fangning Wang, Qiang Yang, Xiaoping Kang, Jianbin Fang, Dongmei Liu, Chengning Shen, Mengfei Li, Yingmin Guan, Wenfeng Wang, Ting Xiao, Fengyun Jiang, Kaiyou Wu, Songguo Wang, Xujie Fu, Lifang Gao, Kai Fu, Xiaojing Duan, Rui Xiao, Ruixia Wu, Hongtu Zhang, Yuerong Ma, Zhonghui Cao, Zhansheng Ba, Wanhai Fu, Jianjun Jiang, Yafei Mi, Shiyu Zheng, Yang Zhong, Fangjiang Li, Xiaoyuan Wang, Pingshuan Dong, Laijing Du, Zhaofa He, Meihua Jin, Zhuoyan Chen, Manli Cheng, Yuqiang Ji, Youhua Zhou, Jvyuan Li, Yizhi Pan, Tianxun Wang, Guiyu Huang, Jianjun Pan, Qingliang Cai, Yuanming Yi, Xuelian Deng, Wenhua Chen, RongCai; Bing Zhang, Yousheng Xu, Zhengqiu Wang, Jun Shu, Puxia Suo, Aimin Zhang, Yongfen Kang, Yuemin Sun, Bo Bian, Xuejun Hu, Dawa Ciren, Guojiong Jia, Jieli Pan, Guofu Li, Hongliang Zhang, Longliang Zhan, Junping Fang, Xinli Yu, Dacheng Wang, Dajun Liu, Xinhong Cao, Haisheng Zhu, Wanchuan Liu, Zhaohai Zhou, Wuwang Fang, Manxin Chen, Fuqin Han, Jianye Fu, Yunmei Wang, Binglu Liu, Yanliang Zhang, Xiupin Yuan, Qingfei Lin, Yuliang Zhu, Zhiqiang Cai, Xingping Li, Lirong Ao, Shubing Wu, Fusheng Zhao, Renfei Liu, Wenwei Ai, Jianbao Chang, Haijie Zhao, Qijun Ran, Xuan Ma, Shijun Jiang, Xiaochun Shu, Zhiru Peng, Jianbin Wang, Li Yang; Yu Shen, Xingcun Shang, Zhisong Liao, Meiying Cai, Lining You, Shuqin Li, Yingjia Li, Jianxun Yang, Song Ai, Jianfei Ma, Lailin Deng, Keyu Wang, Shitang Gao, Banghua He, Youyi Lu, Weirong Yang, Zhizhong Zhang, Xiaohong Chi, Ru Duan, and Guangli Wang
- Subjects
Medicine - Abstract
Objectives To develop a model of in-hospital mortality using medical record front page (MRFP) data and assess its validity in case-mix standardisation by comparison with a model developed using the complete medical record data.Design A nationally representative retrospective study.Setting Representative hospitals in China, covering 161 hospitals in modelling cohort and 156 hospitals in validation cohort.Participants Representative patients admitted for acute myocardial infarction. 8370 patients in modelling cohort and 9704 patients in validation cohort.Primary outcome measures In-hospital mortality, which was defined explicitly as death that occurred during hospitalisation, and the hospital-level risk standardised mortality rate (RSMR).Results A total of 14 variables were included in the model predicting in-hospital mortality based on MRFP data, with the area under receiver operating characteristic curve of 0.78 among modelling cohort and 0.79 among validation cohort. The median of absolute difference between the hospital RSMR predicted by hierarchical generalised linear models established based on MRFP data and complete medical record data, which was built as ‘reference model’, was 0.08% (10th and 90th percentiles: −1.8% and 1.6%). In the regression model comparing the RSMR between two models, the slope and intercept of the regression equation is 0.90 and 0.007 in modelling cohort, while 0.85 and 0.010 in validation cohort, which indicated that the evaluation capability from two models were very similar.Conclusions The models based on MRFP data showed good discrimination and calibration capability, as well as similar risk prediction effect in comparison with the model based on complete medical record data, which proved that MRFP data could be suitable for risk adjustment in hospital performance measurement.
- Published
- 2021
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