The Association Between Hospital Characteristics and Rates of Preventable Complications and Adverse Events

BACKGROUND/OBJECTIVES: This study examined the statistical relationship between hospital ownership and teaching status and hospital rates for potentially preventable adverse events measured using patient safety indicators recently developed by the Agency for Healthcare Research and Quality. RESEARCH DESIGN/MEASURES: A nationally representative sample of hospitals grouped into mutually exclusive combinations of control/ownership, teaching status, and rurality was defined using the Nationwide Inpatient Sample data set for the year 2000. Hospital rates for 5 categories of preventable adverse events were measured in 3 forms: unadjusted, risk-adjusted, and risk-adjusted ratios with smoothing. Multivariable regression analysis was used to measure the statistical significance of the relationship between hospital type and rates for potentially preventable adverse events, with adjustments for differences in hospital bed size and region. RESULTS: This analysis found an inconsistent relationship between categories of hospital type and quality care measured by alternative indicators of potentially preventable conditions. CONCLUSIONS: Hospital ownership and teaching status is not a consistent predictor of differences in rates of potentially preventable adverse events, and these characteristics explain little of the observed variation in the rates of these events across hospitals

Adverse effect · Health care · Patient safety · Rural area · Rurality · Sample size determination · Statistics · Emergency Medicine · Healthcare Policy and Management · Internal Medicine · Medicine · Patient Safety and Medication Errors · Patient Satisfaction in Healthcare

• Nurse Staffing Effects on Patient Outcomes

  Mary A Blegen, Colleen J Goode et al.•Medical Care•2011

  Incluir item

• Do Postoperative Complications Vary by Hospital Teaching Status

  Smruti Vartak, Marcia M Ward et al.•Medical Care•2008

  Incluir item

• Costs of Intravenous Adverse Drug Events in Academic and Nonacademic Intensive Care Units

  Teryl K Nuckols, Susan M Paddock et al.•Medical Care•2008

  Incluir item

• Does the Patient's Payer Matter in Hospital Patient Safety

  Jan P Clement, Richard C Lindrooth et al.•Medical Care•2007

  Incluir item

• Hospital Volume and Surgical Mortality in the United States

  John D Birkmeyer, Andrea E Siewers et al.•New England Journal of Medicine•2002

  Incluir item

• Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

  Linda H Aiken•JAMA•2002

  Incluir item

• Nurse-Staffing Levels and the Quality of Care in Hospitals

  Jacob Needleman, Jack Needleman et al.•New England Journal of Medicine•2002

  Incluir item

• Is Volume Related to Outcome in Health Care? A Systematic Review and Methodologic Critique of the Literature

  Open Access•Ethan A Halm, Clara Lee et al.•Annals of Internal Medicine•2002

  Incluir item

• The Relationship of Hospital Ownership and Teaching Status to 30- and 180-Day Adjusted Mortality Rates

  Evelyn M Kuhn, Arthur J Hartz et al.•Medical Care•1994

  Incluir item

• The Association Between Hospital Type and Mortality and Length of Stay

  Zhong Yuan, Gregory S Cooper et al.•Medical Care•2000

  Incluir item

• Comorbidity Measures for Use with Administrative Data

  Anne Elixhauser, Claudia Steiner et al.•Medical Care•1998

  Incluir item

• Nurse Staffing and Mortality for Medicare Patients with Acute Myocardial Infarction

  Sharina D Person, Sharina Person et al.•Medical Care•2004

  Incluir item

• Adverse Outcomes and Variations in Organization of Care Delivery

  Pamela H Mitchell, Steven M Shortell•Medical Care•1997

  Incluir item