Lawriter - OAC - 4765-4-04 Risk adjustment.

4765-4-04 Risk adjustment.

(A) The purpose of risk adjustment is to identify and control patient variables that are present which may influence patient outcome.

(B) Methodologies:

(1) TRISS shall be the primary methodology used to risk adjust data in the state trauma registry.

(2) Other methodologies may be used by the board to risk adjust data in the data systems.

(3) The coefficients used to calculate TRISS shall be those derived from the MTOS.

(4) The board may evaluate the possibility of creating Ohio specific coefficients, based upon the Ohio trauma registry data set, to utilize with the TRISS methodology, and when appropriate, these equations may be utilized. Additionally, the board may evaluate other appropriate data sets for use in developing specific coefficients.

(C) Analysis:

(1) The board shall utilize a variety of acceptable techniques for providing statistical analysis of risk-adjusted data.

(2) The board shall utilize a variety of methodologies to risk adjust by sex, age, or other factors, in order to analyze data in the data systems for specific age groupings, including pediatric and geriatric age groupings.

(D) Risk adjusted outcomes:

(1) Mortality is an outcome in the state trauma registry. .

(2) The board may evaluate the feasibility of risk adjusting outcome variables.

(E) Risk adjustment deliberations:

(1) The department of public safety, division of EMS, may contract with individuals or organizations with specific expertise in risk adjustment and statistical analysis of medical data in order to perform risk adjustment of information received by the board under Chapter 4765. of the Revised Code.

(2) Each person performing risk adjustment of data has a fiduciary duty to maintain the confidentiality of such information. In the event a person performing risk adjustment under this chapter violates this duty, the department of public safety, division of EMS, may terminate such person and employ any other remedies, legal or equitable, available to it.

(3) Each person performing risk adjustment of data shall sign and adhere to a contract with the department of public safety, division of EMS, regarding the confidentiality of such information. In the event a person performing risk adjustment under this chapter violates any terms of this contract, the department of public safety, division of EMS, may terminate such person and employ any other remedies, legal or equitable, available to it.

(4) All meetings in which persons are engaged in performing risk adjustment functions, including deliberations therein, shall not be open to the public.

(5) All records of deliberations of persons performing risk adjustment functions shall be maintained in confidence.

Effective: 6/1/2018
Five Year Review (FYR) Dates: 1/9/2018 and 11/01/2022
Promulgated Under: 119.03
Statutory Authority: 4765.11, 4765.06
Rule Amplifies: 4765.06
Prior Effective Dates: 04/28/2002, 12/27/2007