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Doody's Review ServiceReviewer: Steven D. Hillson, MD, MSc (University of Minnesota Medical School)
Description: This edited book describes concepts and techniques for risk adjustment in measurement of health outcomes. It contains 11 chapters covering dimensions of risk, sources of risk-related data, how to develop and assess risk-adjustment methods for various outcomes, and comparison of outcomes across providers.
Purpose: The editor's purpose is "to introduce the issues underlying risk adjustment and to suggest important conceptual and methodological considerations in designing and evaluating a risk-adjustment strategy." There is great need for broader familiarity with these issues as public and private payers and care delivery systems attempt to improve their practices and compare them to one another. This book accomplishes its purpose very well.
Audience: This book should prove of great use to students and beginning researchers interested in understanding healthcare delivery and outcomes and to clinical and administrative leaders in insurance and healthcare delivery organizations seeking to evaluate themselves and to understand external evaluations. Selected chapters will be of value to students in medical, nursing, and public health fields concerned with explaining outcome variation or understanding the tools used in their professional literature. The authors bring great credibility to this work, having worked extensively in the development and application of the risk-adjustment tools they discuss.
Features: The book is structured much like a day-long workshop, taking the reader from introductory concepts through development, application, evaluation, and suggestions for use. It makes appropriate use of tables and figures. The language is clear and enjoyable to read. An especially valuable feature is the practical discussion and illustration of several risk assessment tools, including where these tools can be found, what sorts of data are required to use them, and what their relative strengths and weaknesses are. The book is well referenced and current.
Assessment: This is an excellent introductory text, substantially updating the previous edition. It should be on the desk of anyone who is early in a career focused on performing or understanding research in outcome of health care. It will be valuable for the more experienced individual who is moving from one focus and needs to be aware of important differences in risk assessment in a new area. It may be uniquely valuable to teachers and may come to be a standard text for graduate students in this area.