Chen Jersey, Rathore Saif S, Radford Martha J, Krumholz Harlan M
Yale University School of Medicine, USA.
Health Aff (Millwood). 2003 Mar-Apr;22(2):243-54. doi: 10.1377/hlthaff.22.2.243.
We examined the association between JCAHO accreditation of hospitals, those hospitals' quality of care, and survival among Medicare patients hospitalized for acute myocardial infarction. Hospitals not surveyed by JCAHO had, on average, lower quality (less likely to use aspirin, beta-blockers, and reperfusion therapy) and higher thirty-day mortality rates than did surveyed hospitals. However, there was considerable variation within accreditation categories in quality of care and mortality among surveyed hospitals, which indicates that JCAHO accreditation levels have limited usefulness in distinguishing individual performance among accredited hospitals. These findings support current efforts to incorporate quality of care in accreditation decisions.
我们研究了医院联合委员会国际部（JCAHO）对医院的认证、这些医院的医疗质量以及因急性心肌梗死住院的医疗保险患者的生存率之间的关联。未接受JCAHO调查的医院，其医疗质量平均较低（使用阿司匹林、β受体阻滞剂和再灌注治疗的可能性较小），且30天死亡率高于接受调查的医院。然而，在接受调查的医院中，认证类别内的医疗质量和死亡率存在相当大的差异，这表明JCAHO认证水平在区分认证医院的个体表现方面作用有限。这些发现支持了目前将医疗质量纳入认证决策的努力。
