When can we rely on outcome rates - a modelling study analysing medication incidents
Risk-adjustment outcome rates (e.g. death rates and infection rates) are used to monitor hospital performance, on the assumption that high rates reflect poor care.
But high rates of bad outcomes might be false positives, despite risk adjustment.
High rates of false positives waste resources, stigmatise hospitals and lead to gaming the system. False negatives provide false reassurance.
High false positives and negatives occur when the signal (e.g. preventable deaths) gets lost in the noise (e.g. inevitable deaths).
CLAHRC researchers have developed an equation to identify what makes a useful outcome rate.