Summaries of Independent Scientist (K) Awards

Stukenborg, George

Institution: University of Virginia School of Medicine
Grant Title: Mortality Risk Adjustment Using Hospital Claims Data
Grant Number:  K02 HS011419
Duration: 3 years (2002-2005)
Total Award: $198,300

Project Description: This research had four specific aims:

1. Develop improved public domain mortality risk adjustment models for use with administrative data.
2. Rigorously validate the developed models in independent data sets.
3. Compare the new model's statistical performance to that of existing alternatives.
4. Provide Internet-based public access to the developed risk adjustment models.

Career Goals: Dr. Stukenborg is an Assistant Professor in the Department of Health Evaluation Sciences at the University of Virginia School of Medicine in Charlottesville.  He received his Ph.D. in Health Services Research at the Virginia Commonwealth University in Richmond.  His expertise lies in the analysis of population-based data collections.

Progress to Date: This grant has been completed.  The research activities supported by this award demonstrate that mortality risk adjustment methods can be meaningfully improved by using present-at-admission diagnoses to identify comorbid disease.  Models using present-at-admission diagnoses obtain better discrimination between predicted survival and in-patient death, better calibration across ranges of higher mortality risk, and explain more of the observed variation in mortality risk than the other models considered during the research.

 Highlights and Specific Accomplishments:

• Professional Society/Association Memberships:
  • Academy for Health Services Research and Health Policy.
• Agency for Healthcare Research and Quality (AHRQ) Special Emphasis Panel Member.
• National Research Service Awards (NRSA) Institutional Research Training Award.
• Presider of the Statistical Advances and Applications—Posters II session, Statistics program at the 133rd Annual Meeting of the American Public Health Association in New Orleans, Louisiana, 2005.
• AHRQ, Special emphasis panel member for review of applications for RFA HS-03-001, National Research Service Award Institutional Research Training Grants, 2003
• Seventeenth Annual Primary Care Research Methods & Statistics Conference, San Antonio, Texas, National conference session presentation, Title: 'Mortality Risk Adjustment For Comorbid Disease: Methods Matter,' 2002.

K-Generated Publications:

Stukenborg GJ, Wagner DP, Harrell FE. Temporal order and nonlinearity in the relationship between lung cancer resection volume and in-hospital mortality. Health Services and Outcomes Research Methodology 2004. 5:59-73.

Oliver MN, Stukenborg GJ, Wagner DP, Harrell FE, Kilbridge K, Lyman J, Einbinder J, Connors AF. Comorbid disease and the effect of race and ethnicity on in-hospital mortality from aspiration pneumonia. Journal of the National Medical Association 2004. 96(1):1462-69.

Stukenborg GJ, Wagner DP, Harrell FE, Oliver MN, Kilbridge K, Lyman J, Einbinder J, Connors AF. Hospital discharge abstract data on comorbidity improved the prediction of death among patients hospitalized with aspiration pneumonia. Journal of Clinical Epidemiology 2004. 57(5):522-32.

Stukenborg GJ, Wagner DP, Harrell FE, et al. Present-at-admission diagnoses improved mortality risk adjustment among acute myocardial infarction patients. Journal of Clinical Epidemiology 2007. 60:142-54.

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