Improvements in the Distribution of Hospital Performance for the Care of Patients With Acute Myocardial Infarction, Heart Failure, and Pneumonia, 2006–2011

Bibliographic Data

ID9102960
AuthorsSudhakar V Nuti (Yale New Haven Hospital, corresponding author), Yongfei Wang (0009-0000-3231-0749, Yale New Haven Hospital, corresponding author), Frederick A Masoudi (0000-0002-5681-6709, University of Colorado Anschutz Medical Campus), Dale W Bratzler (0000-0002-8033-7521, University of Oklahoma Health Sciences Center), Susannah M Bernheim (0000-0001-5651-9694, Yale New Haven Hospital, corresponding author), Karthik Murugiah (0000-0001-7932-382X, Yale New Haven Hospital, corresponding author), Harlan M Krumholz (0000-0003-2046-127X, Robert Wood Johnson Foundation, corresponding author)
Year2015
Volume53
Issue6
Pages485-491
Publication date2015-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000358
PMID25906012
OpenAlexW2325887330
LanguageEN
Citations received5

BACKGROUND: Medicare hospital core process measures have improved over time, but little is known about how the distribution of performance across hospitals has changed, particularly among the lowest performing hospitals. METHODS: We studied all US hospitals reporting performance measure data on process measures for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PN) to the Centers for Medicare & Medicaid Services from 2006 to 2011. We assessed changes in performance across hospital ranks, variability in the distribution of performance rates, and linear trends in the 10th percentile (lowest) of performance over time for both individual measures and a created composite measure for each condition. RESULTS: More than 4000 hospitals submitted measure data each year. There were marked improvements in hospital performance measures (median performance for composite measures: AMI: 96%-99%, HF: 85%-98%, PN: 83%-97%). A greater number of hospitals reached the 100% performance level over time for all individual and composite measures. For the composite measures, the 10th percentile significantly improved (AMI: 90%-98%, P<0.0001 for trend; HF: 70%-92%, P=0.0002; PN: 71%-92%, P=0.0003); the variation (90th percentile rate minus 10th percentile rate) decreased from 9% in 2006 to 2% in 2011 for AMI, 25%-8% for HF, and 20%-7% for PN. CONCLUSIONS: From 2006 to 2011, not only did the median performance improve but the distribution of performance narrowed. Focus needs to shift away from processes measures to new measures of quality

Acute care · Health care · Heart failure · Medicaid · Myocardial infarction · Percentile · Pneumonia · Statistics · Emergency Medicine · Internal Medicine · Mathematics · Medicine · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes · Sepsis Diagnosis and Treatment