The full content of Annals is available to subscribers

Subscribe/Learn More  >
Ideas and Opinions |

The Risks of Not Adjusting Performance Measures for Sociodemographic FactorsAdjusting Performance Measures for Sociodemographic Factors

Steven H. Lipstein, MHA; and W. Claiborne Dunagan, MD, MS
[+] Article, Author, and Disclosure Information

This article was published online first at www.annals.org on 22 July 2014.

From BJC HealthCare, St. Louis, Missouri.

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1601.

Requests for Single Reprints: Steven H. Lipstein, MHA, BJC HealthCare, 4901 Forest Park Avenue, Suite 1200, St. Louis, MO 63108; e-mail, notestosteve@bjc.org.

Current Author Addresses: Mr. Lipstein: BJC HealthCare, 4901 Forest Park Avenue, Suite 1200, St. Louis, MO 63108.

Dr. Dunagan: BJC Center for Clinical Excellence, 8300 Eager Road, Suite 400A, St. Louis, MO 63144

Author Contributions: Conception and design: S.H. Lipstein, W.C. Dunagan.

Analysis and interpretation of the data: S.H. Lipstein, W.C. Dunagan.

Drafting of the article: S.H. Lipstein, W.C. Dunagan.

Critical revision of the article for important intellectual content: W.C. Dunagan.

Final approval of the article: S.H. Lipstein, W.C. Dunagan.

Statistical expertise: W.C. Dunagan.

Administrative, technical, or logistic support: W.C. Dunagan.

Collection and assembly of data: W.C. Dunagan.

Ann Intern Med. 2014;161(8):594-596. doi:10.7326/M14-1601
Text Size: A A A

The National Quality Forum recently convened on whether to risk-adjust health care performance measures for sociodemographic factors in addition to clinical factors present at the initiation of care. This commentary discusses why the panel chose to recommend such adjustment and why the topic is so hotly debated.

First Page Preview

View Large
First page PDF preview


Grahic Jump Location

St. Louis metropolitan area hospital closures, by poverty level of ZIP code, 1978–2013.

Percentages represent the 2013 poverty rate obtained from Nielsen Pop-Facts Premier 2013.1. New York: The Nielsen Company; 2013. Adapted with permission from Reidhead MC. St. Louis metro area hospital closures over time. Accessed at www.mhanet.com/hidiimages/Hospital_Closures.pdf on 15 July 2014. Copyright 2013 by the Missouri Hospital Association and the Hospital Industry Data Institute.

Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.