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White paper available to explain risk-adjustment model for Leapfrog's resource utilizaton measures

In the 2008 Leapfrog Hospital Survey, hospitals will be asked to report on efficiency of care for four procedures and conditions - coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), acute myocardial infarction (AMI), and Pneumonia.

Efficiency of care for each procedure and condition is a blend of a hospital’s quality score for that procedure or condition with their resource utilization score for that procedure or condition. 

Leapfrog will measure resource utilization for a procedure or condition using a standardized, risk-adjusted, average length of stay inflated by the readmission rate. For each of the four procedures or conditions, hospitals are asked to report their geometric mean length of stay, the number of cases followed by any readmission to that hospital within 14 days for any cause, and a count of cases with certain risk factors present.

The risk-adjustment models Leapfrog is using to adjust the length of stay were developed by the Center for Health Systems Research and Analysis (CHSRA) at the University of Wisconsin – Madison. CHSRA analyzed data from the 2003, 2004 and 2005 National Hospital Discharge Surveys (NHDS) and constructed statistical models appropriate for risk adjustment of average lengths of stay reported by hospitals. Separate models were developed for each of four procedures and conditions: CABG, PCI, AMI and Pneumonia. These models are understandable, simple to apply and have a significant impact on hospital comparisons.   Details of the models can be found in this white paper.