PMID- 28332190
OWN - NLM
STAT- MEDLINE
DCOM- 20190128
LR  - 20190401
IS  - 1475-6773 (Electronic)
IS  - 0017-9124 (Print)
IS  - 0017-9124 (Linking)
VI  - 53
IP  - 2
DP  - 2018 Apr
TI  - Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic 
      Ambulatory Care-Sensitive Conditions in Germany.
PG  - 1180-1202
LID - 10.1111/1475-6773.12680 [doi]
AB  - OBJECTIVES: To explore effects of disease prevalence adjustment on ambulatory 
      care-sensitive hospitalization (ACSH) rates used for quality comparisons. DATA 
      SOURCES/STUDY SETTING: County-level hospital administrative data on adults 
      discharged from German hospitals in 2011 and prevalence estimates based on 
      administrative ambulatory diagnosis data were used. STUDY DESIGN: A retrospective 
      cross-sectional study using in- and outpatient secondary data was performed. DATA 
      COLLECTION: Hospitalization data for hypertension, diabetes, heart failure, 
      chronic obstructive pulmonary disease, and asthma were obtained from the German 
      Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from 
      the German Central Research Institute of Ambulatory Health Care. PRINCIPAL 
      FINDINGS: Crude hospitalization rates varied substantially across counties 
      (coefficients of variation [CV] 28-37 percent across conditions); this variation 
      was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 
      40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all 
      conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas 
      moved into or outside condition-specific control limits with prevalence 
      adjustment. CONCLUSIONS: Unadjusted ACSH rates should be used with caution for 
      high-stakes public reporting as differences in prevalence may have a marked 
      impact. Prevalence adjustment should be considered in models analyzing ACSH.
CI  - (c) Health Research and Educational Trust.
FAU - Pollmanns, Johannes
AU  - Pollmanns J
AD  - Niederrhein University of Applied Sciences, Krefeld, Germany.
FAU - Romano, Patrick S
AU  - Romano PS
AD  - UC Davis Division of General Medicine, Sacramento, CA.
FAU - Weyermann, Maria
AU  - Weyermann M
AD  - Niederrhein University of Applied Sciences, Krefeld, Germany.
FAU - Geraedts, Max
AU  - Geraedts M
AD  - Philipps-Universitat Marburg, Marburg, Germany.
FAU - Drosler, Saskia E
AU  - Drosler SE
AD  - Niederrhein University of Applied Sciences, Krefeld, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170322
PL  - United States
TA  - Health Serv Res
JT  - Health services research
JID - 0053006
SB  - IM
MH  - Benchmarking
MH  - Chronic Disease/*epidemiology
MH  - Cross-Sectional Studies
MH  - Female
MH  - Germany
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Prevalence
MH  - *Quality Indicators, Health Care
MH  - Retrospective Studies
MH  - Risk Adjustment
MH  - Spatial Analysis
PMC - PMC5867184
OTO - NOTNLM
OT  - Ambulatory care-sensitive conditions
OT  - quality of care
OT  - small area analysis
EDAT- 2017/03/24 06:00
MHDA- 2019/01/29 06:00
PMCR- 2019/04/01
CRDT- 2017/03/24 06:00
PHST- 2017/03/24 06:00 [pubmed]
PHST- 2019/01/29 06:00 [medline]
PHST- 2017/03/24 06:00 [entrez]
PHST- 2019/04/01 00:00 [pmc-release]
AID - HESR12680 [pii]
AID - 10.1111/1475-6773.12680 [doi]
PST - ppublish
SO  - Health Serv Res. 2018 Apr;53(2):1180-1202. doi: 10.1111/1475-6773.12680. Epub 
      2017 Mar 22.