Quality

Many hospitals and quality assurance groups have begun to publish online data about quality of care, including process of care measures that indicate how often a hospital adheres to treatment guidelines, according to a study in the Journal of the American Medical Association. The study suggests that hospitals that comply with care guidelines developed by the American College of Cardiology and American Heart Association have improved patient outcomes.

Researchers observed 350 hospitals and 64,775 patients with chest pain or other heart-related problems between Jan. 1, 2001, and Sept. 30, 2003, and examined how often the hospitals complied with care guidelines. Researchers found that:

Hospitals adhered to the guidelines an average of 74% of the time;
Patients at the hospitals with the lowest adherence rates had an in-hospital mortality rate of 6.31%;
Patients receiving treatment at hospitals with the highest levels of adherence had an in-hospital mortality rate of 4.15%;
Every 10% increase in average rates of guideline adherence correlated with a 10% decrease in in-hospital mortality, after risk adjustment; and
Up to 25% of opportunities to follow guidelines were missed.

Researchers suggest that hospital performance measures should be assessed on an ongoing basis because both newer and established care guidelines were found to improve patient outcomes. The study also recommends creating a stronger incentive system for hospitals to follow care guidelines, such as public reporting and pay-for-performance systems, to encourage adherence to evidence-based care practices (Peterson et al., Journal of the American Medical Association, 4/26). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.