UMass Chan Medical School Faculty Publications


Whole-patient measure of safety: using administrative data to assess the probability of highly undesirable events during hospitalization

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Clinical Coding; *Hospitalization; Humans; Medical Errors; *Patient Safety; Probability; Safety Management; United States


Health and Medical Administration | Health Services Administration


Hospitals often have limited ability to obtain primary clinical data from electronic health records to use in assessing quality and safety. We outline a new model that uses administrative data to gauge the safety of care at the hospital level. The model is based on a set of highly undesirable events (HUEs) defined using administrative data and can be customized to address the priorities and needs of different users. Patients with HUEs were identified using discharge abstracts from July 1, 2008 through June 30, 2010. Diagnoses were classified as HUEs based on the associated present-on-admission status. The 2-year study population comprised more than 6.5 million discharges from 161 hospitals. The proportion of hospitalizations including at least one HUE during the 24-month study period varied greatly among hospitals, with a mean of 7.74% (SD 2.3%) and a range of 13.32% (max, 15.31%; min, 1.99%). The whole-patient measure of safety provides a global measure to use in assessing hospitals with the patient's entire care experience in mind. As administrative and clinical datasets become more consistent, it becomes possible to use administrative data to compare the rates of HUEs across organizations and to identify opportunities for improvement.

DOI of Published Version



J Healthc Qual. 2013 Sep-Oct;35(5):20-31. doi: 10.1111/jhq.12027. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Journal for healthcare quality : official publication of the National Association for Healthcare Quality

PubMed ID