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INTER-PROVIDER COMPARISON OF PATIENT-REPORTED OUTCOMES: DEVELOPING AN ADJUSTMENT TO ACCOUNT FOR DIFFERENCES IN PATIENT CASE MIX†
Article first published online: 30 SEP 2013
© 2013 Crown copyright.
Volume 24, Issue 1, pages 41–54, January 2015
How to Cite
2015), INTER-PROVIDER COMPARISON OF PATIENT-REPORTED OUTCOMES: DEVELOPING AN ADJUSTMENT TO ACCOUNT FOR DIFFERENCES IN PATIENT CASE MIX, Health Econ., 24, 41–54, doi: 10.1002/hec.2999, , and (
- Issue published online: 8 DEC 2014
- Article first published online: 30 SEP 2013
- Manuscript Accepted: 27 AUG 2013
- Manuscript Revised: 19 JUN 2013
- Manuscript Received: 20 JAN 2012
- patient-reported outcomes;
- PROMs, case-mix adjustment
This paper describes the development of a methodology for the case-mix adjustment of patient-reported outcome measures (PROMs) data permitting the comparison of outcomes between providers on a like-for-like basis. Statistical models that take account of provider-specific effects form the basis of the proposed case-mix adjustment methodology. Indirect standardisation provides a transparent means of case mix adjusting the PROMs data, which are updated on a monthly basis. Recently published PROMs data for patients undergoing unilateral knee replacement are used to estimate empirical models and to demonstrate the application of the proposed case-mix adjustment methodology in practice. The results are illustrative and are used to highlight a number of theoretical and empirical issues that warrant further exploration. For example, because of differences between PROMs instruments, case-mix adjustment methodologies may require instrument-specific approaches. A number of key assumptions are made in estimating the empirical models, which could be open to challenge. The covariates of post-operative health status could be expanded, and alternative econometric methods could be employed. © 2013 Crown copyright.