Texas Hospital Council Uses AHRQ's Quality Indicators to Link Stroke Deaths With Amphetamine Use
Using AHRQ's Inpatient Quality Indicators (IQIs), the Dallas-Fort Worth Hospital Council helped identify a significant relationship between amphetamine use and inpatient stroke deaths in Texas hospitals. According to Susan McBride, Vice President for the Hospital Council's Data Initiative, this finding has important public health and public policy implications for the state in its efforts to combat amphetamine use.
The Hospital Council, a regional trade association of 73 hospitals located in 19 North Texas counties, facilitates its members' compliance with state law by providing hospital discharge data to the Texas Health Care Information Collection (THCIC) in the Texas Department of State Health Services. The Hospital Council also generates a variety of comparative reports for members using these data. Some of these reports examine member hospitals' experience using a subset of AHRQ's Quality Indicators (QIs), including QIs from the IQIs, Patient Safety Indicator, and Prevention Quality Indicator modules.
McBride says, "The ability to track trends for risk-adjusted mortality rates and to use the detailed IQI data file to examine issues discovered is a useful application of these indicator sets."
For example, about three years ago, a rural Council-member hospital discovered that even after risk adjustment, its IQI for stroke deaths seemed remarkably high. It asked the Hospital Council to investigate. By using the detailed IQI data to analyze the cases in question, it was discovered that the hospital had two unexpected stroke deaths associated with amphetamine use. This early indicator was picked up when working with rural hospitals in an AHRQ grant to support rural hospitals with health information technology implementation to improve patient safety.
With support from the Hospital Council and using THCIC data, a retrospective three-year epidemiological study of all Texas hospitals' experience with inpatient stroke deaths related to amphetamine use was conducted. The study found that there was indeed a statistically significant correlation between rising amphetamine use across the state and stroke deaths at Texas hospitals.
Westover A, McBride S, Haley R. Stroke in young adults who abuse amphetamines or cocaine: A population-based study of hospitalized patients. Archives of General Psychiatry 2007; 64:495-502. Rural Hospital Collaborative for Excellence Using IT (RFA-HS-04-011).