FAILURE RATE: A NEW OUTCOME MEASURE OF QUALITY OF CARE

该项目的目标是进一步开发和验证一种新的 结果衡量标准失败率 通过将死亡率分解为 零部件、不良发生率和故障率， 希望制定出改善医院护理质量的措施。 的 具体目标是：（1）验证，使用更大，更多样化的 数据集，我们早期工作的结果表明， 发生院内不良事件的概率 接受胆囊切除术和胆囊切除术的患者主要是 患者特征的函数，而死亡的概率， 给定不良事件（定义为“失效率”）， 医院特色功能。 因此，我们寻求确认， 预测失败的因素与预测失败的因素是不同的。 死亡或不良事件。 (2)为了检验 技术密集度更高的外科手术模式， 复杂性和医疗条件。 这就需要发展 更细化了不良发生和失效的规范。（三） 用死亡率、失败率来比较医院的排名 和不良发生率超过个人和分组诊断， 程序. (4)更详细地研究那些医院， 死亡率和失败率之间的不同排名。 基于 在上述基础上，这些结果测量的信息价值和内容 将进行评估，并就其申请提出建议， 建议道。

The objective of this project is to further develop and validate a new outcome measure--the failure rate. By dissecting the death rate into its component parts, the adverse-occurrence rate and the failure rate, we hope to develop improved measures of hospital quality of care. The specific aims are: (1) To validate, using a much larger and more diverse data set, the findings of our earlier work which has shown that the probability of developing an in-hospital adverse-occurrence among patients undergoing cholecystectomy and prostatectomy is primarily a function of patient characteristics, while the probability of dying, given an adverse-occurrence (defined as the "failure rate") is more a function of hospital characteristics. Thus, we seek to confirm that the factors which predict failure are distinct from those that predict mortality or adverse-occurrence. (2) To examine the validity of the model for surgical procedures of higher technology intensity and complexity, and for medical conditions. This requires development of more refined specifications of the adverse-occurrence and failure. (3) Compare the rankings of hospitals using mortality rates, failure rates and adverse-occurrence rates over individual and grouped diagnoses and procedures. (4) Study in greater detail those hospitals with very disparate rankings between the death rate and the failure rate. Based on the above, the information value and content of these outcome measures will be assessed and recommendations as to their applications will be suggested.