miércoles, 8 de junio de 2016

Recognizing Differences in Hospital Quality Performance for Pediatric Inpatient Care. - PubMed - NCBI

Recognizing Differences in Hospital Quality Performance for Pediatric Inpatient Care. - PubMed - NCBI



 2015 Aug;136(2):251-62. doi: 10.1542/peds.2014-3131. Epub 2015 Jul 13.

Recognizing Differences in Hospital Quality Performance for Pediatric Inpatient Care.

Abstract

BACKGROUND:

Hospital quality-of-care measures are publicly reported to inform consumer choice and stimulate quality improvement. The number of hospitals and states with enough pediatric hospital discharges to detect worse-than-average inpatient care remains unknown.

METHODS:

This study was a retrospective analysis of hospital discharges for children aged 0 to 17 years from 3974 hospitals in 44 states in the 2009 Kids' Inpatient Database. For 11 measures of all-condition or condition-specific quality, we assessed the number of hospitals and states that met a "power standard" of 80% power for a 5% level significance test to detect when care is 20% worse than average over a 3-year period. For this assessment, we approximated volume as 3 times actual 2009 admission volumes.

RESULTS:

For all-condition quality, 1380 hospitals (87% of all pediatric discharges) and all states met the power standard for the family experience-of-care measure; 1958 hospitals (95% of discharges) and all states met the standard for adverse drug events. For condition-specificquality measures of asthma, birth, and mental health, 203 to 482 hospitals (52%-90% of condition-specific discharges) met the power standard and 40 to 44 states met the standard. One hospital and 16 states met the standard for sickle cell disease. No hospital and ≤27 states met the standard for the remaining measures studied (appendectomy, cerebrospinal fluid shunt surgery, gastroenteritis, heart surgery, and seizure).

CONCLUSIONS:

Most children are admitted to hospitals in which all-condition measures of quality have adequate power to show modestdifferences in performance from average, but most condition-specific measures do not. Policies regarding incentives for pediatric inpatient qualityshould take these findings into account.
Copyright © 2015 by the American Academy of Pediatrics.

PMID:
 
26169435
 
[PubMed - indexed for MEDLINE] 
PMCID:
 
PMC4516938
 [Available on 2016-08-01]

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