Performance and tier-ranking models established by public and private payers are increasingly driving fee structures for hospitals and physicians. Public reporting of this data and an increased focus on comparative effectiveness evaluations can potentially influence a patient choice and patterns of care.

Central to the success of this public outcome reporting is the availability of standardized risk stratification metrics coupled with outcome and cost measures that clinicians and hospitals can use to guide performance. The Risk Stratification Index (RSI) is an open source, nationally validated, risk stratification methodology that permits outcomes such as duration of hospitalization and mortality to be compared equally across institutions.

The RSI models are entirely objective, reproducible, and transparent (they do not include any "adjustments" or subjective "fixes"). They provide a reliable way for hospitals to accurately and independently predict length-of-stay and mortality for surgical patients using only administrative data. Similarly, the system provides a transparent and fair basis for outcome comparisons among hospitals — thereby identifying opportunities for quality of care improvement.

Learn more about the RSI by reading A Broadly Applicable Risk Stratification System for Predicting Duration of Hospitalization and Mortality in the November 2010 issue of Anesthesiology

Zip file contains SPSS code for each of the Risk Stratification Models in SAV and CSV (i.e., Excel) formats. Also enclosed is a sample data file and results which can be used to check that the models are correctly implemented. Start by reviewing "RSI Calculation for Web Use" and "Readme".

Learn about the application of a generalized version of RSI for predicting mortality in adults during the onset of the Covid-19 pandemic by reading Covid-19 and Excess Mortality in Medicare Patients (DOI: TBD.)

Start by reading “HDAI 1-Year Mortality Models Readme” (pdf file).

Learn about a revised and expanded set of RSI models by reading Risk Stratification Index 3.0, a Broad Set of Models for Predicting Adverse Events during and after Hospital Admission in the December 2022 issue of Anesthesiology.

Start with “RSI 3.0 Calculations README” (pdf file).