Metrics on the Risk-Adjusted Analyses

Risk-Adjusted analyses calculate the following metrics:

• Total Cases
• Outcome Cases
• Observed
• Expected
• O/E
• Variation
• Statistical Significance
• Opportunity

These metrics are calculated for the following outcomes

• Charge
• Complications
• Cost
• LOS
• Mortality

Note: For more information, refer to the QualityAdvisor Methodology Guide.

Total Cases

Total Cases are the actual number of cases that qualified for the analysis. This is not a risk-adjusted metric.

Outcome Cases

Outcome Cases are the number of cases that qualified for risk adjustment for each of the given outcomes. Outcome Cases equals the Total Cases minus the cases that did not qualify for risk adjustment. As a result, the number of Outcome Cases may be smaller than the number of Total Cases.

For more information, see Outcome Case Methodology.

Observed

Observed values are the actual rate for the Outcome Cases.

Expected

This is the Expected value for the Outcome Cases based on the risk adjustment methodology: 3M™ or CareScience Analytics.

O/E (Observed to Expected)

O/E is the Observed value (O) divided by the Expected value (E).

• Outcomes with an O/E less than 1.0 are performing better than expected.
• Outcomes with an O/E greater than 1.0 are performing worse than expected.

Variation

Variation is the Observed value minus the Expected value.

• Outcomes with a negative (-) variation are performing better than expected.
• Outcomes with a positive (+) variation are performing worse than expected.

Statistical Significance (SS)

Statistical Significance is the probability that an outcome's Variation (Observed minus Expected value) is not due to random chance.  For more information, see Statistical Significance.

Opportunity

Opportunity metrics are those metrics that show the opportunity for improvement.