National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Cardiovascular Conditions (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Clinician-Patient Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- Critical Care (1)
- Data (1)
- Disparities (1)
- Elderly (4)
- Healthcare-Associated Infections (HAIs) (4)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (3)
- Healthcare Utilization (1)
- Health Systems (1)
- Heart Disease and Health (2)
- Hospitalization (1)
- Hospital Readmissions (2)
- Hospitals (11)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Long-Term Care (3)
- Medicaid (1)
- Medicare (3)
- Mortality (1)
- Newborns/Infants (1)
- Nursing Homes (2)
- Orthopedics (1)
- Patient-Centered Healthcare (1)
- Patient Experience (3)
- Patient Safety (5)
- Payment (3)
- Pneumonia (1)
- Practice Patterns (1)
- Primary Care (1)
- Provider: Physician (1)
- (-) Provider Performance (25)
- Quality Improvement (2)
- Quality Indicators (QIs) (2)
- Quality Measures (3)
- Quality of Care (11)
- Racial and Ethnic Minorities (1)
- Social Media (1)
- Surgery (3)
- Teams (1)
- Training (1)
- Urinary Tract Infection (UTI) (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 25 Research Studies DisplayedSilva GC, Gutman R
Reformulating provider profiling by grouping providers treating similar patients prior to evaluating performance.
The purpose of this study was to explore a novel approach to comparing health providers' performance that identifies groups of providers treating similar populations of patients and then assesses providers' performance within each group. To compare the performance of the proposed approach, the researchers utilized patient-level data from 119 Massachusetts skilled nursing facilities. Simulated and observed outcome data were utilized to examine the performance of the methods in different settings. In simulations, the proposed method classified providers to groups with the admission attributes of similar patients. In the presence of limited overlap in patient attributes across providers and misspecifications of the outcome model, the provider-level estimates created utilizing the novel approach identified providers that under- and overperformed when compared to the existing approaches.
AHRQ-funded; HS026830.
Citation: Silva GC, Gutman R .
Reformulating provider profiling by grouping providers treating similar patients prior to evaluating performance.
Biostatistics 2023 Oct 18; 24(4):962-84. doi: 10.1093/biostatistics/kxac019..
Keywords: Provider Performance, Quality of Care, Healthcare Delivery
Chen Z, Gleason LJ, Konetzka RT
Accuracy of infection reporting in US nursing home ratings.
The objective of this study was to assess the accuracy of publicly reported nursing home data on urinary tract infections (UTIs) and of pneumonia data, which are not publicly reported. Researchers developed a claims-based nursing home-level measure of hospitalized infections and estimated correlations between this and publicly reported ratings. Subjects were Medicare fee-for-service beneficiaries who were nursing home residents and hospitalized for UTI or pneumonia during the study period. Findings suggested that both UTI and pneumonia were substantially underreported in data used for national public reporting. The researchers concluded that alternative approaches were needed to improve surveillance of nursing home quality.
AHRQ-funded; HS026957.
Citation: Chen Z, Gleason LJ, Konetzka RT .
Accuracy of infection reporting in US nursing home ratings.
Health Serv Res 2023 Oct; 58(5):1109-18. doi: 10.1111/1475-6773.14195..
Keywords: Provider Performance, Nursing Homes, Long-Term Care, Pneumonia, Urinary Tract Infection (UTI), Elderly
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N and Rodrick D
Relationship between in-hospital adverse events and hospital performance on 30-day all-cause mortality and readmission for patients with heart failure.
Researchers sought to evaluate the association between hospital performance on mortality and readmission with hospital performance on safety adverse event rates. Their cross-sectional study linked patient-level adverse events data from the Medicare Patient Safety Monitoring System to hospital-level, heart failure (HF)-specific, 30-day, all-cause mortality and readmissions data from CMS. The study included data on over 39,000 patients with HF from over 3000 hospitals. Patients admitted with HF to hospitals with high 30-day, all-cause mortality and readmission rates had a higher risk of in-hospital adverse events. The researchers concluded that there might be common quality issues among the measure concepts in these hospitals that produce poor performance for patients with HF.
AHRQ-funded; AHRQ-authored; 290201800005C.
Citation: Wang Y, Eldridge N, Metersky ML .
Relationship between in-hospital adverse events and hospital performance on 30-day all-cause mortality and readmission for patients with heart failure.
Circ Cardiovasc Qual Outcomes 2023 Jul; 16(7):e009573. doi: 10.1161/circoutcomes.122.009573..
Keywords: Hospitals, Hospital Readmissions, Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Provider Performance
Temkin-Greener H, Mao Y, McGarry B
Online customer reviews of assisted living communities: association with community, county, and state factors.
The authors explored online reviews as a possible source of information about assisted living communities and examined the association between the reviews and aspects of state regulation. They found lower odds of positive reviews in communities with greater proportions of Medicare/Medicaid residents; communities in micropolitan areas and in states with more direct care worker hours had greater odds of a high rating. They concluded that online reviews are a promising source of information about important aspects of satisfaction, particularly in care settings.
AHRQ-funded; HS026893.
Citation: Temkin-Greener H, Mao Y, McGarry B .
Online customer reviews of assisted living communities: association with community, county, and state factors.
J Am Med Dir Assoc 2023 Jun; 24(6):841-45.e3. doi: 10.1016/j.jamda.2023.02.007..
Keywords: Elderly, Provider Performance, Long-Term Care, Medicare
Ye S, Li D, Yu T
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Researchers investigated the effect of surgical volume on the accuracy of identifying poorly performing hospitals. Their research was based on the standardized infection ratio, and they applied their proposed method to data from HCA Healthcare from 2014-2016 on surgical site infections in colon surgery patients. They concluded that minimum surgical volumes and predicted events criteria are required to make hospital evaluation reliable, and that these criteria may vary by overall prevalence and between-hospital variability.
AHRQ-funded; HS027791.
Citation: Ye S, Li D, Yu T .
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Sci Rep 2023 May 10; 13(1):7624. doi: 10.1038/s41598-023-33937-y..
Keywords: Hospitals, Surgery, Healthcare-Associated Infections (HAIs), Provider Performance, Quality of Care
Mao Y, Li Y, McGarry B
Are online reviews of assisted living communities associated with patient-centered outcomes?
The purpose of this study was to explore the relationship between assisted living (AL) online quality review ratings and AL residents' home time. The researchers identified Medicare beneficiaries who entered AL communities in 2018, with the main outcome of resident home time in the year after AL admission. Additional outcomes were the percentage of time spent in emergency room, inpatient hospital, nursing home, and inpatient hospice. The study sample included 59,831 residents in 12,143 ALs. AL online Google reviews for 2013-2017 were linked to 2018-2019 Medicare data. AL average rating score and rating status were generated using Google reviews. The study found that from 2013 to 2017, ALs received an average rating of 4.1 on Google, with a standard deviation of 1.1. Each one-unit increase in the AL's average online rating was associated with an increase in residents' risk-adjusted home time by 0.33 percentage points. Residents in high-rated ALs had a 0.64 pp increase in home time compared with residents in ALs without ratings. Thet study concluded that higher online rating scores were positively associated with residents' home time, and a lack of ratings was related with decreased home time.
AHRQ-funded; HS026893.
Citation: Mao Y, Li Y, McGarry B .
Are online reviews of assisted living communities associated with patient-centered outcomes?
J Am Geriatr Soc 2023 May; 71(5):1505-14. doi: 10.1111/jgs.18192..
Keywords: Elderly, Long-Term Care, Patient-Centered Healthcare, Nursing Homes, Provider Performance, Medicare, Medicaid
Zhou RA, McIntosh N, Rajan R
Association between use of clinician performance information and patient experience.
The objective of this study was to examine the association between the collection and use of clinician performance information in physician practices and patient experience in primary care. Researchers conducted observational multivariant generalized linear regression at the patient level. Patient experience scores were calculated from the 2018-2019 Massachusetts Statewide Survey of Adult Patient Experience of Primary Care. The findings showed that nearly ninety percent of practices in the sample collected or used clinician performance information, which was associated with better primary care patient experience among physician practices. The authors concluded that efforts to use clinician performance information in ways that cultivate clinicians' intrinsic motivation may be especially effective for quality improvement.
AHRQ-funded; HS024075; HS024074.
Citation: Zhou RA, McIntosh N, Rajan R .
Association between use of clinician performance information and patient experience.
Am J Manag Care 2023 Feb;29(2):e51-e57. doi: 10.37765/ajmc.2023.89321.
Keywords: Provider Performance, Patient Experience, Provider: Physician
Carey K, Lin MY
Safety-net hospital performance under comprehensive care for joint replacement.
The objective of this study was to investigate the relative progress of safety-net hospitals (SNHs) under Medicare's Comprehensive Care for Joint Replacement (CJR) mandatory bundled payment model and to identify contributors to SNHs' realization of success under the CJR program. Secondary data on all CJR hospitals from 2016-2020 were taken from CMS public use files and from the American Hospital Association. The findings indicated that SNHs were less successful in meeting spending targets when compared to CJR hospitals overall. The authors concluded that the formula used by CMS to determine spending targets may not be sufficient to address disparities in SNH financial performances under mandatory bundled payment.
AHRQ-funded; HS027786.
Citation: Carey K, Lin MY .
Safety-net hospital performance under comprehensive care for joint replacement.
Health Serv Res 2023 Feb; 58(1):101-06. doi: 10.1111/1475-6773.14042..
Keywords: Hospitals, Surgery, Orthopedics, Provider Performance
Beaulieu ND, Chernew ME, McWilliams JM
Organization and performance of US health systems.
The objectives of this evidence review were to identify and describe health systems in the US, to assess differences between physicians and hospitals in and outside of health systems, and to compare quality and cost of care delivered by physicians and hospitals in and outside of health systems. A total of 580 health systems in a great variety of sizes were identified; prices for physician, hospital services, and total spending were assessed in 2018 commercial claims data. Health system physicians and hospitals were shown to deliver a large portion of medical services. Clinical quality performance and patient experience measures were slightly better in systems; however, spending and prices were significantly higher, especially in small practices. The authors concluded that slight quality differentials in combination with large price differentials suggested that health systems have not realized their potential for better care at equal or lower cost.
AHRQ-funded; HS024072.
Citation: Beaulieu ND, Chernew ME, McWilliams JM .
Organization and performance of US health systems.
JAMA 2023 Jan 24; 329(4):325-35. doi: 10.1001/jama.2022.24032..
Keywords: Health Systems, Healthcare Delivery, Provider Performance, Quality Measures, Quality of Care, Hospitals
Quigley DD, Elliott MN, Slaughter ME
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
The purpose of this study was to explore whether a second shadow coaching session (re-coaching) improves the patient experience and maintains it over time. The researchers observed a statistically significant increase of 3.7 points among re-coached providers after re-coaching on overall provider rating (OPR) and 3.5 points on provider communication (PC) (differences of 1, 3, and 5 points or more are considered small, medium, and large, respectively). Improvements from the re-coaching endured for 12 months for OPR and 8 months for PC.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
J Gen Intern Med 2023 Jan; 38(1):221-27. doi: 10.1007/s11606-022-07881-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care, Clinician-Patient Communication, Patient Experience, Provider Performance
Nembhard IM, Matta S, Shaller D
Learning from patients: the impact of using patients' narratives on patient experience scores.
The purpose of this study was to assess whether primary care clinics that often share patients' narratives with their staff have higher patient experience survey scores. The researchers conducted a 1-year study of 5,545 adult patients and 276 staff affiliated with nine clinics in one health system. The study found the frequency of sharing useful narratives with staff was related with patient experience scores for all measures, a result which was conditional upon staff confidence in their own knowledge. For operational measures such as care coordination, higher levels of sharing was associated with subsequently higher performance for more confident staff and lower performance or no difference for less confident staff, depending on the measure. For relational measures such as patient-provider communication, increased sharing was associated with higher scores for less confident staff and lower scores for more confident staff.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Matta S, Shaller D .
Learning from patients: the impact of using patients' narratives on patient experience scores.
Health Care Manage Rev 2023 Jan-Mar; 49(1):2-13. doi: 10.1097/hmr.0000000000000386..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance
Doherty JR, Schaefer A, Goodman DC
Texas hospital's perspectives about NICU performance measures: a mixed-methods study.
This exploratory mixed-methods study was conducted to determine Texas hospital leaders’ perspectives about neonatal intensive care (NICU) performance measures. First a survey was sent along with a copy of the Dartmouth Atlas of Neonatal Intensive Care to clinical and administrative leaders of 150 NICUs in Texas. The authors asked respondents to review the chapter that reported Texas-specific results and respond to a variety of open and closed-ended questions about the overall usefulness of the report. Secondly, they conducted semistructured qualitative interviews with a subset of survey respondents to better understand their perspectives. There was a 50% survey response rate. Respondents generally found the report to be interesting and useful, and 87.7% of all respondents reported being in favor of receiving future reports with their own hospital's data benchmarked against other anonymous NICU peers. All measures in the Atlas were considered favorably. The respondents also felt that a report with performance data would serve as a mechanism to drive change by identifying opportunities for improvement.
AHRQ-funded; HS024075.
Citation: Doherty JR, Schaefer A, Goodman DC .
Texas hospital's perspectives about NICU performance measures: a mixed-methods study.
Qual Manag Health Care 2023 Jan-Mar;32(1):8-15. doi: 10.1097/qmh.0000000000000347..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Provider Performance, Hospitals
Catchpole K, Neyens DM, Abernathy J
Framework for direct observation of performance and safety in healthcare.
This viewpoint paper discusses non-participant direct observation of healthcare processes as a rich method for understanding safety and performance improvement. The authors suggest that as a prospective method for error prediction and modelling, observation can capture a broad range of performance issues that can be related to higher aspects of the system.
AHRQ-funded; HS024380.
Citation: Catchpole K, Neyens DM, Abernathy J .
Framework for direct observation of performance and safety in healthcare.
BMJ Qual Saf 2017 Dec;26(12):1015-21. doi: 10.1136/bmjqs-2016-006407..
Keywords: Healthcare Delivery, Patient Safety, Provider Performance, Quality Improvement
Paddock SM, Damberg CL, Yanagihara D
What role does efficiency play in understanding the relationship between cost and quality in physician organizations?
Previous studies demonstrate overuse of a narrow set of services, suggesting provider inefficiency, but existing studies neither quantify inefficiency more broadly nor assess its variation across physician organizations (POs). This study found that POs had substantial variation in efficiency, producing widely differing levels of quality for the same cost.
AHRQ-funded; HS021860.
Citation: Paddock SM, Damberg CL, Yanagihara D .
What role does efficiency play in understanding the relationship between cost and quality in physician organizations?
Med Care 2017 Dec;55(12):1039-45. doi: 10.1097/mlr.0000000000000823.
.
.
Keywords: Practice Patterns, Healthcare Costs, Quality of Care, Quality Improvement, Payment, Provider Performance
Masnick M, Morgan DJ, Sorkin JD
Can national healthcare-associated infections (HAIs) data differentiate hospitals in the United States?
This study was designed to determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. The authors concluded that HAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI.
AHRQ-funded; HS018111.
Citation: Masnick M, Morgan DJ, Sorkin JD .
Can national healthcare-associated infections (HAIs) data differentiate hospitals in the United States?
Infect Control Hosp Epidemiol 2017 Oct;38(10):1167-71. doi: 10.1017/ice.2017.179..
Keywords: Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance, Quality Measures
Adams JL, Paddock SM
Misclassification risk of tier-based physician quality performance systems.
The authors estimated misclassification rates for two-category high-quality physician identification systems. They found that current methods for profiling physicians on quality may produce misleading results, and that misclassification is a policy-relevant measure of the potential impact of tiering on providers, payers, and patients. They concluded that quantifying misclassification rates should inform the construction of high-performance networks and quality improvement initiatives.
AHRQ-funded; HS021860.
Citation: Adams JL, Paddock SM .
Misclassification risk of tier-based physician quality performance systems.
Health Serv Res 2017 Aug;52(4):1277-96. doi: 10.1111/1475-6773.12561.
.
.
Keywords: Provider Performance, Quality of Care, Payment
Smith SN, Reichert HA, Ameling JM
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Voluntary Leapfrog Safe Practices Score (SPS) measures were among the first public reports of hospital performance. Recently, Medicare's Hospital Compare website has reported compulsory measures. Leapfrog's Hospital Safety Score (HSS) grades incorporate SPS and Medicare measures. The researchers evaluated associations between Leapfrog SPS and Medicare measures. They found that voluntary Leapfrog SPS measures skew toward positive self-report and bear little association with compulsory Medicare outcomes and penalties.
AHRQ-funded; HS019767; HS024385; HS018334.
Citation: Smith SN, Reichert HA, Ameling JM .
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Med Care 2017 Jun;55(6):606-14. doi: 10.1097/mlr.0000000000000716.
.
.
Keywords: Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance
DeLancey JO, Softcheck J, Chung JW
Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings.
This study evaluated associations between hospital characteristics, number and types of measures reported, and the star ratings. Of 3,591 hospitals receiving a star rating,4 or 5 stars were awarded to 15.8 percent of major teaching hospitals, 18.8 percent of other teaching hospitals, 30.2 percent of community hospitals, 33.3 percent of critical access hospitals, and 87.3 percent of specialty hospitals.
AHRQ-funded; HS021857.
Citation: DeLancey JO, Softcheck J, Chung JW .
Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings.
JAMA 2017 May 16;317(19):2015-17. doi: 10.1001/jama.2017.3148.
.
.
Keywords: Hospitals, Quality of Care, Quality Measures, Provider Performance, Patient Safety
Fernandez R, Shah S, Rosenman ED
Developing team cognition: a role for simulation.
Evidence from team science research demonstrates a strong relationship between team cognition and team performance and suggests a role for simulation in the development of this team-level construct. In this article, the researchers synthesize research from the broader team science literature to provide foundational knowledge regarding team cognition and highlight best practices for using simulation to target team cognition.
AHRQ-funded; HS020295; HS022458.
Citation: Fernandez R, Shah S, Rosenman ED .
Developing team cognition: a role for simulation.
Simul Healthc 2017 Apr;12(2):96-103. doi: 10.1097/sih.0000000000000200.
.
.
Keywords: Teams, Training, Provider Performance, Patient Safety
Mendelson A, Kondo K, Damberg C
The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review.
This review updated and expanded a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. It found that pay-for-performance programs may be associated with improved processes of care in ambulatory settings, but consistently positive associations with improved health outcomes have not been demonstrated in any setting.
AHRQ-funded; HS022981.
Citation: Mendelson A, Kondo K, Damberg C .
The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review.
Ann Intern Med 2017 Mar 7;166(5):341-53. doi: 10.7326/m16-1881.
.
.
Keywords: Payment, Provider Performance, Healthcare Utilization, Quality of Care
Lewis VA, Fraze T, Fisher ES
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Researchers analyzed racial and ethnic disparities in health care outcomes among accountable care organizations (ACOs). Their findings suggest that ACOs with a high share of minority patients may struggle with quality performance under ACO contracts, especially during their early years of participation-maintaining or potentially exacerbating current inequities.
AHRQ-funded; HS024075.
Citation: Lewis VA, Fraze T, Fisher ES .
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Health Aff 2017 Jan;36(1):57-66. doi: 10.1377/hlthaff.2016.0626.
.
.
Keywords: Disparities, Racial and Ethnic Minorities, Provider Performance, Quality Indicators (QIs), Quality of Care
Davis JD, Olsen MA, Bommarito K
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
In this study, the researchers investigated readmission characteristics and the magnitude of 30-day hospital readmissions after hospital discharge for heart failure using the Healthcare Cost and Utilization Project State Inpatient Databases (SID). They found in this large all-payer cohort, ∼70% of 30-day readmissions were for non-heart failure causes, and the median time to readmission was 12 days.
AHRQ-funded; HS019455.
Citation: Davis JD, Olsen MA, Bommarito K .
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
Am J Med 2017 Jan;130(1):93.e9-93.e28. doi: 10.1016/j.amjmed.2016.07.030..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitalization, Hospitals, Provider Performance
Govindan S, Chopra V, Iwashyna TJ
Do clinicians understand quality metric data? An evaluation in a Twitter-derived sample.
The researchers assessed clinician comprehension of central line-associated blood stream infection (CLABSI) quality metric data. It found that the mean percentage of correct answers was 61 percent. Overall, doctor performance was better than performance by nurses and other respondents. In basic numeracy, mean percent correct was 82 percent. For risk-adjustment numeracy, the mean percent correct was 70 percent.
AHRQ-funded; HS022835.
Citation: Govindan S, Chopra V, Iwashyna TJ .
Do clinicians understand quality metric data? An evaluation in a Twitter-derived sample.
J Hosp Med 2017 Jan;12(1):18-22.
.
.
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Data, Quality of Care, Provider Performance, Social Media
George EI, Ročková V, Rosenbaum PR
Mortality rate estimation and standardization for public reporting: Medicare’s Hospital Compare.
The authors calibrated Bayesian recommendation systems by checking, out of sample, whether predictions aggregate to give correct general advice derived from another sample. Their process leads to substantial revisions in the Hospital Compare model for acute myocardial infarction mortality. They found that indirect standardization, as currently used by Hospital Compare, fails to adequately control for differences in patient risk factors and systematically underestimates mortality rates at the low volume hospitals. They proposed direct standardization instead.
AHRQ-funded; HS021854.
Citation: George EI, Ročková V, Rosenbaum PR .
Mortality rate estimation and standardization for public reporting: Medicare’s Hospital Compare.
Journal of the American Statistical Association 2017;112(519):933-47. doi: 10.1080/01621459.2016.1276021.
.
.
Keywords: Hospitals, Medicare, Mortality, Provider Performance
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
.
.
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly