Attribution: Whose complication is it?

摘要

BACKGROUND: To improve quality, programs such as accountable care organizations need to determine the part of the health care system most "responsible'' for a complication. This is referred to as attribution. This provides a framework to compare physicians for patients and third-party payers. Traditionally, the attribution of complications has been to the admitting physician. This may misidentify the physician "responsible'' for the complication. This is especially difficult in trauma patients who have multiple providers. We hypothesized that the current mechanism for attributing complications in trauma patients is inadequate and will need to be modernized.