Examination of Hospital Characteristics and Patient Quality Outcomes Using Four Inpatient Quality Indicators and 30-Day All-Cause Mortality

Abstract

The study objective was to examine hospital mortality outcomes and structure using 2008 patient-level discharges from general community hospitals. Discharges from Florida administrative files were merged to the state mortality registry. A cross-sectional analysis of inpatient mortality was conducted using Inpatient Quality Indicators (IQIs) for acute myocardial infarction (AMI), congestive heart failure (CHF), stroke, pneumonia, and all-payer 30-day postdischarge mortality. Structural characteristics included bed size, volume, ownership, teaching status, and system affiliation. Outcomes were risk adjusted using 3M APR-DRG. Volume was inversely correlated with AMI, CHF, stroke, and 30-day mortality. Similarities and differences in the direction and magnitude of the relationship of structural characteristics to 30-day postdischarge and IQI mortality measures were observed. Hospital volume was inversely correlated with inpatient mortality outcomes. Other hospital characteristics were associated with some mortality outcomes. Further study is needed to understand the relationship between 30-day postdischarge mortality and hospital quality.

Hospital Characteristics and the Agency for Healthcare Research and Quality Inpatient Quality Indicators: A Systematic Review

“…Sixteen studies examined the association of hospital characteristics with the IQIs (Table 2). Five focused on bed size, (Bradley et al, 2010;Carretta et al, 2013;Chukmaitov et al, 2009;Friedman and Jiang, 2010;Sochalski et al, 2008), nine on teaching status, (Bradley et al, 2010;Carretta et al, 2013;Chukmaitov et al, 2009;Friedman and Jiang, 2010;Srinivas et al, 2010;Volpp et al, 2007a;Weiner et al, 2006), four on nurse staffing, (Gaskin et al, 2011;Sochalski et al, 2008;Trinkoff et al, 2011;Weiner et al, 2006), and five on hospital ownership (Bradley et al, 2010;Chukmaitov et al, 2009;Gaskin et al, 2011;Sochalski et al, 2008;Weiner et al, 2006). Other characteristics were addressed in only a few articles (from one to three each).…”

Quality of Acute Care and Long-Term Quality of Life and Survival

“…[3][4][5][6][7][8] We aimed to determine the relationship between receiving combinations of 3 recommended processes of acute care in hospital (referred herein as quality indicators) and patient outcomes ≤180 days after the onset of stroke, assessing the differences by stroke type.…”

The effects of shared situational awareness on functional and hospital outcomes of hospitalized older adults with heart failure

“…The APR-DRG data were gathered based on the 3M Health Information Systems (Salt Lake City, UT, USA) tools. The APR-DRG has been used elsewhere for adjusting severity of illness in hospitalized patients with heart failure 27. Hospital nursing staff collected cognitive data using the Mini-Cog™ screen (University of Washington, Seattle, WA, USA), which had the highest sensitivity (99%) and correctly classified the greatest percentage (96%) of subjects 28.…”