League Tables for Hospital Comparisons

Abstract

We review statistical methods for estimating and interpreting league tables used to infer hospital quality with a primary focus on methods for partitioning variation into two types: (a) that associated with within-hospital variation for a homogeneous group of patients and (b) that produced by between-hospital variation. We discuss the types of covariates included in the model, hierarchical and nonhierarchical logistic regression models for conducting inferences in a low-information context and their associated trade-offs, and the role of hospital volume. We use all-cause mortality rates for US hospitals to illustrate concepts and methods.