Table_1_基于健康索赔数据的德国医院急性脓毒症护理长期结局风险调整质量指标的开发与验证

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• 源站标题：Table_1_Development and validation of risk-adjusted quality indicators for the long-term outcome of acute sepsis care in German hospitals based on health claims data.DOCX
• DOI：10.3389/fmed.2022.1069042.s002
• 发布日期：2023-01-09
• 文件数：1 个
• 文件总体积：708.46 KB
• 源站页面：https://frontiersin.figshare.com/articles/dataset/Table_1_Development_and_validation_of_risk-adjusted_quality_indicators_for_the_long-term_outcome_of_acute_sepsis_care_in_German_hospitals_based_on_health_claims_data_DOCX/21837966

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• Table_1_Development and validation of risk-adjusted quality indicators for the long-term outcome of acute sepsis care in German hospitals based on hea.DOCX（708.46 KB）

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数据说明

BackgroundMethods for assessing long-term outcome quality of acute care for sepsis are lacking. We investigated a method for measuring long-term outcome quality based on health claims data in Germany.
Materials and methodsAnalyses were based on data of the largest German health insurer, covering 32% of the population. Cases (aged 15 years and older) with ICD-10-codes for severe sepsis or septic shock according to sepsis-1-definitions hospitalized in 2014 were included. Short-term outcome was assessed by 90-day mortality; long-term outcome was assessed by a composite endpoint defined by 1-year mortality or increased dependency on chronic care. Risk factors were identified by logistic regressions with backward selection. Hierarchical generalized linear models were used to correct for clustering of cases in hospitals. Predictive validity of the models was assessed by internal validation using bootstrap-sampling. Risk-standardized mortality rates (RSMR) were calculated with and without reliability adjustment and their univariate and bivariate distributions were described.
ResultsAmong 35,552 included patients, 53.2% died within 90 days after admission; 39.8% of 90-day survivors died within the first year or had an increased dependency on chronic care. Both risk-models showed a sufficient predictive validity regarding discrimination [AUC = 0.748 (95% CI: 0.742; 0.752) for 90-day mortality; AUC = 0.675 (95% CI: 0.665; 0.685) for the 1-year composite outcome, respectively], calibration (Brier Score of 0.203 and 0.220; calibration slope of 1.094 and 0.978), and explained variance (R2 = 0.242 and R2 = 0.111). Because of a small case-volume per hospital, applying reliability adjustment to the RSMR led to a great decrease in variability across hospitals [from median (1st quartile, 3rd quartile) 54.2% (44.3%, 65.5%) to 53.2% (50.7%, 55.9%) for 90-day mortality; from 39.2% (27.8%, 51.1%) to 39.9% (39.5%, 40.4%) for the 1-year composite endpoint]. There was no substantial correlation between the two endpoints at hospital level (observed rates: ρ = 0, p = 0.99; RSMR: ρ = 0.017, p = 0.56; reliability-adjusted RSMR: ρ = 0.067; p = 0.026).
ConclusionQuality assurance and epidemio

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学术使用请引用 DOI 10.3389/fmed.2022.1069042.s002（source: https://frontiersin.figshare.com/articles/dataset/Table_1_Development_and_validation_of_risk-adjusted_quality_indicators_for_the_long-term_outcome_of_acute_sepsis_care_in_German_hospitals_based_on_health_claims_data_DOCX/21837966）。