Prior Risk Of Death (part 2)
I attempt to derive a more sophisticated measure for how sick in-patients are in the first instance and find something rather unexpected
In part 1 of this mini series I introduced the concept of PROD (prior risk of death) as being an embellishment on the total number of diagnoses made in the EPR. I’m pretty sure that readers will understand why it is vital to assess just how ill folk were prior to admission and death, even for a sample of deceased patients, so today I will pursue the most peculiar finding of a drop-off in diagnosed conditions for the elderly.
The more I think about it the variable I am calling prior risk of death (PROD) is essentially prior risk of diagnosis. Hence it will favour the more common entries in the EPR. The danger here is to have minor conditions like the common cold dominate matters, which is why the score was derived using 11 major morbidity groupings rather than an abundance of specific and somewhat trivial diagnoses.
With all that said and done here’s another break down by age band but for the number of diagnoses made per patient prior to death:
If we compare this to the slides presented in part 1 of this series we observe an increase in case complexity all the way through a peak in the 90 – 94y age band, whereas the PROD peak stops short in the in the 70 – 74y age band. Curious indeed that a complexity score should out-run the commonality score.
Keep reading with a 7-day free trial
Subscribe to John Dee's Almanac to keep reading this post and get 7 days of free access to the full post archives.