Hospitals, health insurers and patients may have to reconsider previously established approaches to asessing hospital quality. A new study from the Yale School of Medicine supports measuring patient deaths over a period of 30 days from admission even after they have left the hospital.
The study, published in the Annals of Internal Medicine, compared two widely used approaches to assessing hospital quality: using mortality rates of patients who die during their initial hospitalization, and using rates of patients who die within 30 days, whether or not they have been discharged.
Researchers focused on mortality rates for patients with heart attack, heart failure, and pneumonia. For these conditions, one-third to one-half of deaths within 30 days occur after the patient leaves the hospital, but this proportion often varies by hospital.
Researchers felt that only counting deaths during the initial hospitalization could be misleading because some hospitals keep their patients for less time than others due to patient transfers to other facilities or because they send patients home more quickly.
The study revealed that quality at many U.S. hospitals looked different using the two different accounting methods. and that measures looking only at deaths in the hospital favor hospitals that keep their patients for a shorter length of time.
The study has wide implications as quality measures take on more importance in the healthcare system, say researchers. It further has implications for any study that compares hospitals using patient outcomes to judge quality.
Source: Yale School of Medicine, January 3, 2012
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