RE: O/E Model

The Midas Model is copyrighted, but I think I can share the common concepts, which may be helpful to those that were requesting info about Mortality Reporting.
Bottom Line is what all of us have always stated, acuity matters, and need to look deeper than CC/MCC Capture.


APR DRG

Description of the APR DRG.

# Cases Number of cases that were assigned this APR DRG at the facility.

Observed Mortality Observed number of deaths among patients with the APR DRG at the facility.

Expected Mortality Expected number of deaths for the APR DRG. To calculate this value, the facility's
volume of encounters for each mortality-risk level (1–4) is divided by the CDB
volume of encounters for that level, and then multiplied by the CDB observed
number of deaths for the same level.

Mortality O/E Ratio The facility’s observed number of deaths divided by the expected number of
deaths. A value less than 1.0 is better than expected. A value greater than 1.0 is
worse than expected.

When interpreting the report, you should take into account the number of cases.
O/E Percentile Percentile for the facility's O/E ratio value compared with the CDB mean
performance.

# of Sites Number of participating facilities in the comparative pool.



Paul Evans, RHIA, CCS, CCS-P, CCDS
 
Manager, Regional Clinical Documentation
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell:  415.412.9421



evanspx@sutterhealth.org

Comments

  • Paul,
    Our Database analyst that deals with MIDAS told me that up until now MIDAS has used APR methodology but they just changed to their own (more specific) methodology. She gave me a pile of information to sort through but I have not gotten to that yet.

    Is what you referring to the old or new methodology?

    Thanks!

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • I am told our Midas Team is using a proprietary formula to compute outcomes, but that APR w/ ROM is still used for input. If you have more details, please share!

    Thanks, Paul

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.412.9421



    evanspx@sutterhealth.org




  • I'll let you know when I wade through the 100pg document she sent ;-)

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404


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