Variation in hospital mortality rates for patients... [Am J Cardiol. 2010] - PubMed result

Am J Cardiol. 2010 Oct 15;106(8):1108-12.
Variation in hospital mortality rates for patients with acute myocardial infarction.
Bradley EH, Herrin J, Curry L, Cherlin EJ, Wang Y, Webster TR, Drye EE, Normand SL, Krumholz HM.
SourceSection of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA. Elizabeth.bradley@yale.edu


Abstract
Hospitals vary by twofold in their hospital-specific 30-day risk-stratified mortality rates (RSMRs) for Medicare beneficiaries with acute myocardial infarction (AMI). However, we lack a comprehensive investigation of hospital characteristics associated with 30-day RSMRs and the degree to which the variation in 30-day RSMRs is accounted for by these characteristics, including the socioeconomic status (SES) profile of hospital patient populations. We conducted a cross-sectional national study of hospitals with ≥15 AMI discharges from July 1, 2005 to June 20, 2008. We estimated a multivariable weighted regression using Medicare claims data for hospital-specific 30-day RSMRs, American Hospital Association Survey of Hospitals for hospital characteristics, and the United States Census data reported by Neilsen Claritas, Inc., for zip-code level estimates of SES status. Analysis included 2,908 hospitals with 513,202 AMI discharges. Mean hospital 30-day RSMR was 16.5% (SD 1.7 percentage points). Our multivariable model explained 17.1% of the variation in hospital-specific 30-day RSMRs. Teaching status, number of hospital beds, AMI volume, cardiac facilities available, urban/rural location, geographic region, ownership type, and SES profile of patients were significantly (p < 0.05) associated with 30-day RSMRs. In conclusion, substantial variation in hospital outcomes for patients with AMI remains unexplained by measurements of hospital characteristics including SES patient profile. Copyright © 2010 Elsevier Inc. All rights reserved. PMID:20920648[PubMed - indexed for MEDLINE] Variation in hospital mortality rates for patients... [Am J Cardiol. 2010] - PubMed result