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Updated: Aug 17, 2026

Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
Comparing alternative risk-adjustment models
1Washington Institute for Mental Illness Research and Training, Washington State University, Spokane 99201, USA. hendryx@wsu.edu
Abstract:
The use of mental health indicators to compare provider performance requires that comparisons be fair. Fair provider comparisons mean that scores are risk adjusted for client characteristics that influence scores and that are beyond provider control. Data for the study are collected from 336 outpatients receiving publicly funded mental health services in Washington State. The study compares alternative specifications of multiple regression-based risk-adjustment models to argue that the particular form of the model will lead to different conclusions about comparative treatment agency performance. In order to evaluate performance fairly it is necessary to not only incorporate risk adjustment, but also identify the most correct form that the risk-adjustment model should take. Future research is needed to specify; test, and validate the mental health risk-adjustment models best suited to particular treatment populations and performance indicators.
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