Guided Notes

Risk Adjustment & Observed/Expected Ratios

Why raw comparisons are unfair, how expected rates are built from patient risk, observed-to-expected (O/E) ratios, indirect standardization, and how public ratings use them.

Why risk adjust

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Hospital A has 4% mortality; Hospital B has 6%. Is A better? Not if B is a trauma center treating far sicker patients. Risk adjustment estimates what each provider's outcomes would be expected to be given its patients' characteristics (age, diagnoses, severity, comorbidities), then compares actual results to that expectation.