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Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure

Hospitals with high mortality and readmission rates for patients with heart failure (HF) might also perform poorly in other quality concepts. We sought to evaluate the association between hospital performance on mortality and readmission with hospital performance rates of safety adverse events. METH...

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Autores principales: Wang, Yun, Eldridge, Noel, Metersky, Mark L., Rodrick, David, Eckenrode, Sheila, Mathew, Jasie, Galusha, Deron H., Peterson, Andrea A., Hunt, David, Normand, Sharon-Lise T., Krumholz, Harlan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351904/
https://www.ncbi.nlm.nih.gov/pubmed/37463255
http://dx.doi.org/10.1161/CIRCOUTCOMES.122.009573
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author Wang, Yun
Eldridge, Noel
Metersky, Mark L.
Rodrick, David
Eckenrode, Sheila
Mathew, Jasie
Galusha, Deron H.
Peterson, Andrea A.
Hunt, David
Normand, Sharon-Lise T.
Krumholz, Harlan M.
author_facet Wang, Yun
Eldridge, Noel
Metersky, Mark L.
Rodrick, David
Eckenrode, Sheila
Mathew, Jasie
Galusha, Deron H.
Peterson, Andrea A.
Hunt, David
Normand, Sharon-Lise T.
Krumholz, Harlan M.
author_sort Wang, Yun
collection PubMed
description Hospitals with high mortality and readmission rates for patients with heart failure (HF) might also perform poorly in other quality concepts. We sought to evaluate the association between hospital performance on mortality and readmission with hospital performance rates of safety adverse events. METHODS: This cross-sectional study linked the 2009 to 2019 patient-level adverse events data from the Medicare Patient Safety Monitoring System, a randomly selected medical records-abstracted patient safety database, to the 2005 to 2016 hospital-level HF-specific 30-day all-cause mortality and readmissions data from the United States Centers for Medicare & Medicaid Services. Hospitals were classified to one of 3 performance categories based on their risk-standardized 30-day all-cause mortality and readmission rates: better (both in <25th percentile), worse (both >75th percentile), and average (otherwise). Our main outcome was the occurrence (yes/no) of one or more adverse events during hospitalization. A mixed-effect model was fit to assess the relationship between a patient's risk of having adverse events and hospital performance categories, adjusted for patient and hospital characteristics. RESULTS: The study included 39 597 patients with HF from 3108 hospitals, of which 252 hospitals (8.1%) and 215 (6.9%) were in the better and worse categories, respectively. The rate of patients with one or more adverse events during a hospitalization was 12.5% (95% CI, 12.1–12.8). Compared with patients admitted to better hospitals, patients admitted to worse hospitals had a higher risk of one or more hospital-acquired adverse events (adjusted risk ratio, 1.24 [95% CI, 1.06–1.44]). CONCLUSIONS: 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. There may be common quality issues among these 3 measure concepts in these hospitals that produce poor performance for patients with HF.
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spelling pubmed-103519042023-07-18 Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure Wang, Yun Eldridge, Noel Metersky, Mark L. Rodrick, David Eckenrode, Sheila Mathew, Jasie Galusha, Deron H. Peterson, Andrea A. Hunt, David Normand, Sharon-Lise T. Krumholz, Harlan M. Circ Cardiovasc Qual Outcomes Original Articles Hospitals with high mortality and readmission rates for patients with heart failure (HF) might also perform poorly in other quality concepts. We sought to evaluate the association between hospital performance on mortality and readmission with hospital performance rates of safety adverse events. METHODS: This cross-sectional study linked the 2009 to 2019 patient-level adverse events data from the Medicare Patient Safety Monitoring System, a randomly selected medical records-abstracted patient safety database, to the 2005 to 2016 hospital-level HF-specific 30-day all-cause mortality and readmissions data from the United States Centers for Medicare & Medicaid Services. Hospitals were classified to one of 3 performance categories based on their risk-standardized 30-day all-cause mortality and readmission rates: better (both in <25th percentile), worse (both >75th percentile), and average (otherwise). Our main outcome was the occurrence (yes/no) of one or more adverse events during hospitalization. A mixed-effect model was fit to assess the relationship between a patient's risk of having adverse events and hospital performance categories, adjusted for patient and hospital characteristics. RESULTS: The study included 39 597 patients with HF from 3108 hospitals, of which 252 hospitals (8.1%) and 215 (6.9%) were in the better and worse categories, respectively. The rate of patients with one or more adverse events during a hospitalization was 12.5% (95% CI, 12.1–12.8). Compared with patients admitted to better hospitals, patients admitted to worse hospitals had a higher risk of one or more hospital-acquired adverse events (adjusted risk ratio, 1.24 [95% CI, 1.06–1.44]). CONCLUSIONS: 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. There may be common quality issues among these 3 measure concepts in these hospitals that produce poor performance for patients with HF. Lippincott Williams & Wilkins 2023-07-18 2023-07 /pmc/articles/PMC10351904/ /pubmed/37463255 http://dx.doi.org/10.1161/CIRCOUTCOMES.122.009573 Text en © 2023 The Authors. https://creativecommons.org/licenses/by/4.0/Circulation: Cardiovascular Quality and Outcomes is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
spellingShingle Original Articles
Wang, Yun
Eldridge, Noel
Metersky, Mark L.
Rodrick, David
Eckenrode, Sheila
Mathew, Jasie
Galusha, Deron H.
Peterson, Andrea A.
Hunt, David
Normand, Sharon-Lise T.
Krumholz, Harlan M.
Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
title Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
title_full Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
title_fullStr Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
title_full_unstemmed Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
title_short Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
title_sort relationship between in-hospital adverse events and hospital performance on 30-day all-cause mortality and readmission for patients with heart failure
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351904/
https://www.ncbi.nlm.nih.gov/pubmed/37463255
http://dx.doi.org/10.1161/CIRCOUTCOMES.122.009573
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