Chen J, Radford M J, Wang Y, Marciniak T A, Krumholz H M
Yale University, USA.
Health Aff (Millwood). 1999 Jul-Aug;18(4):53-68. doi: 10.1377/hlthaff.18.4.53.
We examine whether Medicare patients with acute myocardial infarction (AMI) admitted to one of HCIA-Mercer's "100 top hospitals" received better care or had better outcomes than patients treated in other hospitals. Among four hospital peer groups, the top 100 hospitals had similar thirty-day mortality and use of aspirin, beta-blockers, and reperfusion compared with their peers, but lower lengths-of-stay and in-hospital costs, with similar or lower readmission rates. Our findings suggest that the 100 Top Hospitals study may be better suited for identifying hospitals with higher performance on financial and operating measures than superior clinical performance in treating elderly AMI patients. However, there was no evidence that quality was sacrificed for increased financial efficiency among the top 100 hospitals.
我们研究了入住HCIA-美世公司“百强医院”之一的急性心肌梗死（AMI）医疗保险患者是否比在其他医院接受治疗的患者得到了更好的护理或有更好的治疗结果。在四个医院同类组中，百强医院与同行相比，30天死亡率以及阿司匹林、β受体阻滞剂的使用和再灌注情况相似，但住院时间更短、住院费用更低，再入院率相似或更低。我们的研究结果表明，百强医院研究可能更适合识别在财务和运营指标方面表现较高的医院，而非在治疗老年AMI患者方面具有卓越临床表现的医院。然而，没有证据表明百强医院为了提高财务效率而牺牲了质量。
