Open AccessPrediction of Hospital Acute Myocardial Infarction and Heart Failure 30‐Day Mortality Rates Using Publicly Reported Performance Measures
Author(s) -
Aaronson David S.,
Bardach Naomi S.,
Lin Grace A.,
Chattopadhyay Arpita,
Goldman L. Elizabeth,
Dudley R. Adams
Publication year - 2013
Publication title -
journal for healthcare quality
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.374
H-Index - 27
eISSN - 1945-1474
pISSN - 1062-2551
DOI - 10.1111/j.1945-1474.2011.00173.x
Subject(s) - decile , medicine , medicaid , myocardial infarction , mortality rate , emergency medicine , heart failure , observational study , demography , health care , statistics , mathematics , sociology , economics , economic growth
Objective To identify an approach to summarizing publicly reported hospital performance data for acute myocardial infarction ( AMI ) or heart failure ( HF ) that best predicts current year hospital mortality rates. Setting A total of 1,868 U . S . hospitals reporting process and outcome measures for AMI and HF to the C enters for M edicare and M edicaid S ervices ( CMS ) from J uly 2005 to J une 2006 (Year 0) and J uly 2006 to J une 2007 (Year 1). Design Observational cohort study measuring the percentage variation in Year 1 hospital 30‐day risk‐adjusted mortality rate explained by denominator‐based weighted composite scores summarizing hospital Year 0 performance. Data Collection Data were prospectively collected from hospitalcompare.gov . Results Percentage variation in Year 1 mortality was best explained by mortality rate alone in Year 0 over other composites including process performance. If only Year 0 mortality rates were reported, and consumers using hospitals in the highest decile of mortality instead chose hospitals in the lowest decile of mortality rate, the number of deaths at 30 days that potentially could have been avoided was 1.31 per 100 patients for AMI and 2.12 for HF ( p < .001). Conclusion Public reports focused on 30‐day risk‐adjusted mortality rate may more directly address policymakers’ goals of facilitating consumer identification of hospitals with better outcomes.