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Variability in Case-mix Adjusted In-hospital Cardiac Arrest Rates

Datos Bibliográficos

ID9101067
AutoresRaina M Merchant (0000-0002-9801-6881, Children's Hospital of Philadelphia, autor de correspondencia), Lin Yang (0000-0002-1698-6666, General Department of Preventive Medicine), Lance B Becker (0000-0001-7051-8778, autor de correspondencia), Robert A Berg (0000-0001-5529-9431, Philadelphia University), Vinay Nadkarni (0000-0002-3794-5599, Philadelphia University), Graham Nichol (0000-0002-2670-0000, University of Washington), Brendan G Carr (0000-0002-9147-9701, autor de correspondencia), Nandita Mitra (0000-0002-7714-3910, University of Pennsylvania), Steven M Bradley (0000-0003-4006-6760, University of Washington), Benjamin S Abella (0000-0003-2521-0891, autor de correspondencia), Peter W Groeneveld (0000-0002-7374-4292, General Department of Preventive Medicine)
Año2012
Volumen50
Número2
Páginas124-130
Fecha de publicación2012-02-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31822d5d17
PMID22249921
PMCIDPMC3260453
OpenAlexW2077713838
IdiomaEN
Citas recibidas1
Referencias citadas27

BACKGROUND: It is unknown how in-hospital cardiac arrest (IHCA) rates vary across hospitals and predictors of variability. OBJECTIVES: Measure variability in IHCA across hospitals and determine if hospital-level factors predict differences in case-mix adjusted event rates. RESEARCH DESIGN: Get with the Guidelines Resuscitation (GWTG-R) (n=433 hospitals) was used to identify IHCA events between 2003 and 2007. The American Hospital Association survey, Medicare, and US Census were used to obtain detailed information about GWTG-R hospitals. PARTICIPANTS: Adult patients with IHCA. MEASURES: Case-mix-adjusted predicted IHCA rates were calculated for each hospital and variability across hospitals was compared. A regression model was used to predict case-mix adjusted event rates using hospital measures of volume, nurse-to-bed ratio, percent intensive care unit beds, palliative care services, urban designation, volume of black patients, income, trauma designation, academic designation, cardiac surgery capability, and a patient risk score. RESULTS: We evaluated 103,117 adult IHCAs at 433 US hospitals. The case-mix adjusted IHCA event rate was highly variable across hospitals, median 1/1000 bed days (interquartile range: 0.7 to 1.3 events/1000 bed days). In a multivariable regression model, case-mix adjusted IHCA event rates were highest in urban hospitals [rate ratio (RR), 1.1; 95% confidence interval (CI), 1.0-1.3; P=0.03] and hospitals with higher proportions of black patients (RR, 1.2; 95% CI, 1.0-1.3; P=0.01) and lower in larger hospitals (RR, 0.54; 95% CI, 0.45-0.66; P<0.0001). CONCLUSIONS: Case-mix adjusted IHCA event rates varied considerably across hospitals. Several hospital factors associated with higher IHCA event rates were consistent with factors often linked with lower hospital quality of care

Case mix index · Confidence interval · Intensive care unit · Interquartile range · Cardiac Arrest and Resuscitation · Demography · Emergency Medicine · Internal Medicine · Medicine · Sepsis Diagnosis and Treatment · Simulation-Based Education in Healthcare

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Obras citantes distintas1
Citas por año0,1
Intervalo de citas2016 - 2016 (1)
Velocidad de citaciónhistorical
Altamente citadoNo
Tipos de citaNeutras: 1
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