# Benchmarking Hospital Quality: Template Matching versus Conventional Regression Approaches

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2020 · —

## Abstract

Background: Identifying and remediating low-quality care is at the heart of systematic quality improvement,
particularly in VA. However, cross-hospital comparisons to identify under-performing hospitals are limited by
differences in patient case-mix and illness severity. Clinicians consider the current approach to benchmarking
with conventional regression to be unfair, unclear, and unhelpful. While substantial resources are devoted to
hospital benchmarking, the current return on this investment is limited because clinicians do not understand or
trust the methods. The National Academy of Medicine has recently called for investing into the science of
performance measurement and for increasing its transparency and validity. Template matching has been
proposed as an alternative methodological approach to benchmarking that is fair, clear, and helpful. However,
this new approach has never been tested outside of limited research settings.
Specific Aims: To test the utility of template matching for comparing quality of care across VA's diverse acute
care hospitals, this project will assess the feasibility, accuracy, and interpretability of this approach.
Specifically, the project will: (A1) Feasibility: Develop and optimize two template matching approaches for
comparing 30-day mortality across VA hospitals. (A2) Accuracy: Compare the ability of template matching
versus conventional regression to correctly identify under-performing hospitals. (A3) Interpretability: Compare
the interpretability and credibility of hospital performance data generated from template matching versus
conventional regression models with clinical leaders.
Anticipated Impact: The overarching goal of this proposal is to improve the care of hospitalized Veterans.
This proposal will apply promising, new template matching approaches for benchmarking to the diverse VA
healthcare system and complete a multi-faceted evaluation of these approaches. We will consider not only the
feasibility and methodological rigor of template matching, but also the interpretability, credibility and
accountability of the data. We expect that template matching will be feasible for benchmarking VA acute care
hospitals, that it will identify under-performing hospitals at least as well as current benchmarking with
conventional regression, and that it will be more interpretable and credible to VA Chiefs of Medicine than
current performance reports. We anticipate many future expansions to this work, including the use of template
matching for VA to private sector comparisons.
Unique Features and Innovation: This proposal is innovative because it will simultaneously (1) advance the
statistical state-of-the-art in hospital benchmarking, (2) develop the necessary infrastructure in consultation
with operational partners to use template matching in VA, and (3) evaluate this new approach not just
statistically, but also with the actual users it is supposed to inform. The results are highly relevant to VA, whose
performa...

## Key facts

- **NIH application ID:** 9679239
- **Project number:** 5I01HX002546-02
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Hallie Christine Prescott
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-03-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9679239

## Citation

> US National Institutes of Health, RePORTER application 9679239, Benchmarking Hospital Quality: Template Matching versus Conventional Regression Approaches (5I01HX002546-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9679239. Licensed CC0.

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