Efficacy of Statistical Outlier Analysis for Monitoring Quality of Care

Kurt D Gillis and Jesse S Hixson

Journal of Business & Economic Statistics, 1991, vol. 9, issue 3, 241-52

Abstract: Researchers have proposed that hospitals with excessive statistically unexplained mortality rates are more likely to have quality of care problems. The U.S. Health Care Financing Administration uses this statistical "outlier" approach to screen for poor quality hospitals. Little is known, however, about the validity of this technique because direct quality measures are difficult to obtain. Monte Carlo methods are employed to evaluate outlier technique performance as parameters of the true mortality process are varied. Results suggest that screening performance is very sensitive to variation in quality related mortality across hospitals, but insensitive to other factors generally thought to be important.

Date: 1991
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