Selecting patient factors for risk adjustment in health outcomes assessments

Risk adjustment is used in health outcomes assessments to control for differences in patient risk factors. Appropriate risk adjustment requires that important risk factors be identified and included for data collection. These risk factors must be chosen carefully based on the disease state being assessed, the outcomes being evaluated, and consideration of other factors that may influence the outcomes assessment, This column outlines a series of practical steps for selecting appropriate risk factors for outcomes assessments. It illustrates how these steps may be applied using the example of a health system's assessment of appropriate ACE inhibitor use for patients with congestive heart failure.