Hierarchical causal variance decomposition for institution and provider comparisons in healthcare

نویسندگان

چکیده

Disease-specific quality indicators are used to compare institutions and health care providers in terms of processes or outcomes relevant treatment a particular condition. In the context surgical cancer treatments, performance variations can be due hospital and/or surgeon level differences, creating hierarchical clustering. We consider how observed variation received at patient decomposed into that causally explained by performance, within hospital, case-mix, unexplained (residual) variation. For this purpose, we derive four-way variance decomposition, with attention causal interpretation components. estimation, use inputs from mixed-effect model nested random hospital/surgeon-specific effects, multinomial logistic for populations. investigate our methods simulation study demonstrate them through analysis administrative data on kidney Ontario.

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ژورنال

عنوان ژورنال: Health Services and Outcomes Research Methodology

سال: 2023

ISSN: ['1387-3741', '1572-9400']

DOI: https://doi.org/10.1007/s10742-023-00301-6