@article {573296,
	title = {A cost-effectiveness framework for profiling the value of hospital care},
	journal = {Med Decis Making},
	volume = {28},
	number = {3},
	year = {2008},
	month = {2008 May-Jun},
	pages = {419-34},
	abstract = {Provider profiling and performance-based incentive programs have expanded in recent years but need a theoretical framework for measuring and comparing the "value{\textquoteright}{\textquoteright} of clinical care across medical providers. Cost-effectiveness analysis provides such a framework but has rarely been used outside of the treatment choice context. The authors present a profiling framework based on cost-effectiveness methods and illustrate their approach using data on in-hospital survival and the cost of care for a heart attack from a sample of Massachusetts hospitals during fiscal year 2003. They model each outcome using hierarchical models that allow performance to vary across hospitals as a function of a latent quality effect and an effect of case mix. They also estimate incremental outcomes by conditioning on each hospital{\textquoteright}s pair of random effects, using indirect standardization to estimate "expected{\textquoteright}{\textquoteright} outcomes, and then taking their difference. Incremental cost and effectiveness outcomes are combined using incremental net monetary benefits. Using cost-effectiveness methods to profile hospital "value{\textquoteright}{\textquoteright} permits the comparison of the benefit of a service relative to the cost using existing societal weights.},
	keywords = {Aged, Cost-Benefit Analysis, Female, Financing, Personal, Hospitalization, Humans, Male, Massachusetts, Models, Statistical, Myocardial Infarction, Outcome Assessment (Health Care), Quality of Health Care, Risk Adjustment, Survival Analysis},
	issn = {0272-989X},
	doi = {10.1177/0272989X07312476},
	author = {Timbie, Justin W and Joseph P. Newhouse and Meredith B. Rosenthal and Normand, Sharon-Lise T.}
}
