Thank You

Thank you for submitting your responses to the questions on "What do you know?" in the section on risk assessment. I have received your responses and will respond to them in a few days.

Correct Responses

Here are what I consider to be correct responses to the questions:

What problems do you think reliance on ICD-9-cm codes create for measuring severity of illness.

ICD9 codes reflect the entire stays and thus they include iatrogenic diseases caused by poor care. Relying on these information to examine risk adjusted outcomes of care may lead to erroneous conclusion about quality of care.
What is an ordinal scale, what is an interval scale, and why would you prefer one to the other?

Ordinal numbers preserve the rank order of items. Interval scales preserve both the rank as well as extent of severity. An interval scale can be averaged an ordinal scale cannot. Whenever possible, it is better to rely on interval scale.
Which do you think is more likely to be affected by treatment, physiological markers collected during the first 24 hour of admission or ICD-9-CM codes classifying the purpose of the hospitalization?

Both. ICD-9 codes reflect iatrogenic diseases due to poor care (e.g. a patients' fall). Physiological markers reflect steps taken to stabilize patient on route to care (e.g. giving medication to a heart attack patient on route to the hospital).

Copyright © 1996 Farrokh Alemi, Ph.D. Created on Saturday, September 21, 1996. Most recent revision 05/03/2015. This page is part of the course on Quality / Process Improvement. To return to the lecture on severity of illness, click here.