{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T17:08:01Z","timestamp":1756573681762},"reference-count":19,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Computational and Mathematical Methods in Medicine"],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:p>The ratio of observed-to-expected deaths is considered a measure of hospital quality and for this reason will soon become a basis for payment. However, there are drivers of that metric more potent than quality: most important are medical documentation and patient acuity. If hositals underdocument and therefore do not capture the full \u201cexpected mortality\u201d they may be tempted to lower their observed\/expected ratio by reducing \u201cobserved mortality\u201d through limiting access to the very ill. Underdocumentation occurs because hospitals do not recognize, and therefore cannot seek to confirm, specific comorbidities conferring high mortality risk. To help hospitals identify these comorbidities, this paper describes an easily implemented spread-sheet for evaluating comorbid conditions associated, in any particular hospital, with each discharge. This method identifies comorbidities that increase in frequency as mortality risk increases within each diagnostic grouping. The method is inductive and therefore independent of any particular risk-adjustment technique.<\/jats:p>","DOI":"10.1155\/2012\/829465","type":"journal-article","created":{"date-parts":[[2012,3,15]],"date-time":"2012-03-15T21:55:38Z","timestamp":1331848538000},"page":"1-5","source":"Crossref","is-referenced-by-count":16,"title":["Risk-Adjusted Mortality: Problems and Possibilities"],"prefix":"10.1155","volume":"2012","author":[{"given":"Daniel","family":"Shine","sequence":"first","affiliation":[{"name":"Department of Medicine, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016, USA"}]}],"member":"98","reference":[{"issue":"3","key":"1","first-page":"367","volume":"29","year":"1994","journal-title":"Health Services Research"},{"issue":"2","key":"2","first-page":"128","volume":"30","year":"1993","journal-title":"Inquiry"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.251.5.637"},{"issue":"24","key":"5","doi-asserted-by":"crossref","first-page":"3617","DOI":"10.1001\/jama.1988.03410240087037","volume":"260","year":"1988","journal-title":"JAMA"},{"issue":"4","key":"6","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1097\/00005650-199104000-00001","volume":"29","year":"1991","journal-title":"Medical Care"},{"key":"7","year":"2001"},{"issue":"8","key":"8","first-page":"666","volume":"127","year":"1997","journal-title":"Annals of Internal Medicine"},{"issue":"2","key":"9","first-page":"2","volume":"2011","year":"2011","journal-title":"Health Care Law Monthly"},{"issue":"19","key":"10","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1001\/jama.1997.03550190064046","volume":"278","year":"1997","journal-title":"JAMA"},{"issue":"5","key":"11","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/BF02598273","volume":"11","year":"1996","journal-title":"Journal of General Internal Medicine"},{"issue":"10","key":"12","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.2105\/AJPH.86.10.1379","volume":"86","year":"1996","journal-title":"American Journal of Public Health"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e318065c101"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.10.010"},{"issue":"15","key":"16","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1001\/jama.1988.03410150088036","volume":"260","year":"1988","journal-title":"JAMA"},{"issue":"1","key":"19","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","volume":"36","year":"1998","journal-title":"Medical Care"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318158aed6"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00554.x"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.267.16.2197"},{"issue":"8","key":"23","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1097\/00005650-199308000-00005","volume":"31","year":"1993","journal-title":"Medical Care"}],"container-title":["Computational and Mathematical Methods in Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cmmm\/2012\/829465.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cmmm\/2012\/829465.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cmmm\/2012\/829465.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,20]],"date-time":"2017-06-20T15:39:48Z","timestamp":1497973188000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/cmmm\/2012\/829465\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":19,"alternative-id":["829465","829465"],"URL":"https:\/\/doi.org\/10.1155\/2012\/829465","relation":{},"ISSN":["1748-670X","1748-6718"],"issn-type":[{"value":"1748-670X","type":"print"},{"value":"1748-6718","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012]]}}}