The 2003 Index of Hospital Quality

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Reputation Structure The reputational score is based on cumulative information from three NORC surveys of physicians carried out in 2001, 2002, and 2003. For the 2001 and 2003 surveys, the samples consisted of 2,550 board-certified physicians selected from the American Medical Association (AMA) Physician Masterfile of approximately 811,000 physicians. In 2002 the overall sample size was increased from 2,550 to 3,060 to test response rates when administering a short form questionnaire versus a long form questionnaire. The samples of physicians for each year were stratified by region and by specialty within region. We selected a sample of 150 physicians for each of the 17 specialty areas in both 2001 and 2003. In 2002, 180 physicians were selected in each specialty. The final aggregated sample includes both non-federal and federal medical and osteopathic physicians residing in the fifty states and the District of Columbia. The structural score is based on data related to the structural characteristics of each specialty within each hospital. These elements represent volume of work, technology, and other characteristics of the hospital environment. The majority of the data elements are derived from the 2001 AHA Annual Survey. The volume data are taken from the MEDPARS database, maintained by the Centers for Medicare and Medicaid Services (CMS). It contains information on all Medicare discharges in each specialty. CMS is the federal agency formerly known as the Health Care Financing Administration (HCFA). 2
Mortality The outcomes measure is based on CMS’s MEDPARS database. An adjusted mortality rate for each hospital and specialty is computed based on predicted and actual mortality rates by MEDSTAT Group, Inc. of Franklin, Tenn., using the All Patient Refined Diagnosis Related Group (APR-DRG) method designed by 3M Health Information Systems. The APR-DRG adjusts expected deaths for severity of illness by means of principal diagnosis and categories of secondary diagnoses. The method is applied to the pooled 1999, 2000 and 2001 set of Medicare reimbursement claims made to CMS by hospitals. A detailed description of these components follows in Section II of this report. For a more exhaustive review of the foundation as well as of the development and use of the individual measures and the composite index, see “Best Hospitals: A Description of the Methodology for the Index of Hospital Quality.” 3 3
Page 1 and 2: The 2003 Index of Hospital Quality
Page 3 and 4: NORC 6126
Page 5: I Introduction Health care provider
Page 9 and 10: We then created separate analytic u
Page 11 and 12: Figure 2. Analysis Procedure for
Page 13 and 14: Figure 3. Technology Indices by Spe
Page 15 and 16: Figure 4. Percentile Where Volume a
Page 17 and 18: 8) Gynecology services: This indica
Page 19 and 20: Figure 5. Factor Loading by Special
Page 21 and 22: Eligibility requirements We defined
Page 23 and 24: Stratification To compensate for th
Page 25 and 26: Figure 7. Response Rate by Year* Sp
Page 27 and 28: D. Outcome Many healthcare professi
Page 29 and 30: dampen the effect of year-to-year f
Page 31 and 32: IHQ scores for the specialties of E
Page 33 and 34: F. Summary of Changes for 2003 •
Page 35 and 36: IV References 1. Donabedian A. Eval
Page 37 and 38: V Appendices
Page 39 and 40: The following variables, used to co
Page 41 and 42: Geriatrics Technology Index 1 point
Page 43 and 44: Geriatric Services 1 point if ADULT
Page 45: Appendix B 2002 Sample Physician Qu
Page 53 and 54: Appendix D Predicted Mortality: APR
Page 55 and 56: Current AP-DRG Structure In 1987, t
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All Patient Refined DRGs APR-DRG Ob
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Phase I have their own hierarchical
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Phase II C All secondary diagnoses
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Figure 4. Minimum Severity of Illne
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Phase II C All secondary diagnoses
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Cancer 2003 Diagnosis-Related Group
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#206 DISORDERS OF LIVER EXCEPT MALI
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Heart and Heart Surgery #75 MAJOR C
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Neurology and Neurosurgery #1 CRANI
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Respiratory Disorders #76 OTHER RES
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Appendix F Index of Hospital Qualit
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2003 Digestive Disorders Best Hospi
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2003 Geriatrics Best Hospital List
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2003 Heart and Heart Surgery Best H
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2003 Kidney Disease Best Hospital L
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2003 Orthopedics Best Hospital List
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2003 Rheumatology Best Hospital Lis
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Appendix G Reputation Rankings for
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2003 Pediatrics Reputational Score
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2003 Rehabilitation Reputational Sc
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The Honor Roll To lend additional p
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Contact Information This document c
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The 2003 Index of Hospital Quality

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