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HRET Health Research & Educational Trust of New Jersey
ResearchOngoing Projects
Comparative Clinical Outcomes
Every year since 1995, HRET has prepared and released a series of comparative data on certain quality measures as a tool to assist hospitals in identifying opportunities to improve the quality of care rendered to their communities. The data presented in this report are derived from the New Jersey Uniform Bill-Patient Summary (UB-PS) data that are collected by the New Jersey Discharge Data Collection System for all inpatients discharged from acute care hospitals in New Jersey. To meaningfully analyze the UB-PS data, this report uses a subset of data available from the QuanTIM Performance Measurement System, a clinical outcome evaluation system developed jointly by QuadraMed and the New Jersey Hospital Association. A statistical risk-adjustment method is used to account or control for patient characteristics and conditions that are clinically meaningful and have demonstrated a statistical effect on the rates for each condition. QuanTIM Performance Measurement System utilizes a stepwise logistic regression procedure to select variables included in the prediction models. This helps decrease the effect of a hospital treating a group of patients who may be more severely ill or more likely to have a specific outcome than patients treated at other hospitals.
Each annual report contains the actual unadjusted raw rates for three to five years of data for each outcomes measure and the risk-adjusted predicted rate of the most recent year. The predicted rates represent the mid-point of the predicted range at a confidence level of 95 percent. A symbol is used to represent the difference between a hospital's actual rate and its predicted rate for each year. Rates are reported for all NJHA member hospitals. Also included in each year are the mean rates for all hospitals in the state as well as for various peer group categories. These rates provide an opportunity for hospitals to benchmark and assist in comparative evaluation of hospital outcomes. Each report includes the following topics:
- Primary cesarean sections;
- Vaginal births after cesarean section;
- Myocardial infarction mortality;
- Heart failure mortality;
- Community acquired pneumonia mortality; and,
- Postoperative infections for surgical inpatients.
Two topics (heart failure mortality and community acquired pneumonia mortality) were selected from the Center for Medicaid and Medicare Services' Seventh Scope of Work and included in this report as an effort to assist hospitals with their voluntary and mandatory outcomes measures reporting. To further support hospitals in their mandatory reporting, one topic from JCAHO required measures (postoperative infections for surgical inpatients) was also recently included in this report.
Method of calculation of rates for each topic is described in the report. The best way to utilize the Comparative Clinical Outcomes Report (CCOR) is to integrate it into the hospital's quality improvement efforts. The report may help in identifying the areas that:
- May require improvement in the quality of care provided or the process through which the care is delivered;
- Offer examples of especially good processes of care that can be used as a model to improve other processes; and,
- Require improvement in coding procedures, the development of consistent coding guidelines or improvement in documentation of care actually rendered.
All hospitals are now familiar with the data released through CCOR and many are using the longitudinal report of actual rates and risk-adjusted predicted rates to improve their patient outcomes.
This report is distributed only to hospital CEOs and QA executives due to confidentiality of the included data.
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