The risks of risk adjustment

Article Abstract:

Adjusting a hospital's death rates to account for differences in patient characteristics will produce different results depending on what severity index is used. Severity indexes use different patient characteristics to determine a hospital patient's risk of death. Researchers used over a dozen severity indexes to adjust 1991 mortality data from 108 hospitals for heart attack, stroke, pneumonia and coronary bypass surgery. The ranking of many hospitals varied dramatically depending on which severity index was used. However, risk adjustment is still necessary to avoid penalizing hospitals that treat high-risk patients.

Risk assessment, Evaluation, Hospitals, Physicians, Medical professions, Health status indicators

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When walking fails

Article Abstract:

A physician who has multiple sclerosis describes what physicians can do to help their patients with disabilities that affect their ability to walk. About 35 million Americans have some type of disability that affects mobility. The most common causes are hip fracture, stroke, osteoporosis, arthritis, vision disorders and diabetes. Physicians should toss out old beliefs that people with walking disabilities have extreme limitations. They should refer patients to a physical therapist and try to keep information in their waiting room about special services for the disabled.

Social aspects, Physician and patient, Physician-patient relations, Behavior, Disabled persons

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A 44-Year-Old Woman With Difficulty Walking

Article Abstract:

About 49 million Americans have a disability of some kind, generating about $160 billion annually in direct medical expenditures and $155 billion from lost productivity and other indirect costs. Many assistive devices are available but some third-party payers may not cover them.

Analysis, Disability, Disabilities, Self-help devices for the disabled, Assistive technology devices

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