Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure-Reference-Cited by-同舟云学术

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

Published:2023-07 Issue:7 Volume:16 Page:
ISSN:1941-7713
Container-title:Circulation: Cardiovascular Quality and Outcomes
language:en
Short-container-title:Circ: Cardiovascular Quality and Outcomes

Author:

Wang Yun¹²,Eldridge Noel³⁴,Metersky Mark L.⁵^ORCID,Rodrick David³,Eckenrode Sheila¹^ORCID,Mathew Jasie¹^ORCID,Galusha Deron H.⁶^ORCID,Peterson Andrea A.⁷⁸,Hunt David⁹^ORCID,Normand Sharon-Lise T.¹⁰¹¹^ORCID,Krumholz Harlan M.¹²¹²^ORCID

Affiliation:

1. Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT (S.E., J.M., H.M.K., Y.W.).

2. Section of Cardiovascular Medicine (H.M.K., Y.W.), Department of Internal Medicine, Yale School of Medicine, New Haven, CT.

3. Agency for Healthcare Research and Quality (D.R., N.E.), both from the United States Department of Health and Human Services, Rockville, MD.

4. Defense Health Agency, Falls Church, Virginia (N.E.).

5. University of Connecticut School of Medicine, Farmington, CT (M.L.M.).

6. Section of General Internal Medicine (D.H.G.), Department of Internal Medicine, Yale School of Medicine, New Haven, CT.

7. Hartford Healthcare, Trumbull, CT (A.A.P.).

8. St. Vincent’s Hospital, Bridgeport, CT (A.A.P.).

9. Office of the National Coordinator for Health Information Technology (D.H.), both from the United States Department of Health and Human Services, Rockville, MD.

10. Department of Health Care Policy, Harvard Medical School, Boston, MA (S.-L.T.N.).

11. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA (S.-L.T.N.).

12. Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (H.M.K.).

Abstract

BACKGROUND: 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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

Reference20 articles.

1. Centers for Disease Control and Prevention National Center for Health Statistics. Underlying Cause of Death 1999–2017. Accessed January 7 2019.

2. Healthcare Cost and Utilization Project. Healthcare Cost and Utilization Project Fast Stats. Rockville MD: Agency for Healthcare Research and Quality; 2021.www.hcup-us.ahrq.gov/faststats/national/inpatientcommondiagnoses.jsp?year1=2015&characteristic1=0&included1=0&year2=2014&characteristic2=0&included2=0&expansionInfoState=hide&dataTablesState=hide&definitionsState=show&exportState=hide.

3. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association

4. Trends in Adverse Event Rates in Hospitalized Patients, 2010-2019

5. Centers for Medicare and Medicaid Services. Hospital Readmissions Reduction Program (HRRP). 2020. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program. Accessed April 16 2022.