Risk adjustment and outcome research. Part I

Abstract

It is becoming increasingly important for policy makers and planners to identify which factors may improve or worsen the effectiveness of treatments and services and to compare the performances of providers. Politicians, managers, epidemiologists, and clinicians should make their decisions based on the validity and precision of study results, by using the best scientific knowledge available. The statistical methods described in this review cannot measure 'reality' as it 'truly' is, but can produce 'images' of it, defining limits and uncertainties in terms of validity and precision. Studies that use credible risk-adjustment strategies are more likely to yield reliable and applicable findings.