Jessee W F, Schranz C M
Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL 60181.
Qual Assur Health Care. 1990;2(2):137-44. doi: 10.1093/intqhc/2.2.137.
In 1987, the Health Care Financing Administration (HCFA) compiled and released mortality information for 1986 Medicare admissions to 5,971 United States hospitals. Full triennial accreditation surveys were conducted by the Joint Commission on Accreditation of Healthcare Organizations in 1,628 of these institutions in 1986. This report examines the relationship between 1986 Medicare mortality rates and hospital quality, as measured by accreditation survey performance. Hospitals with higher-than-expected and lower-than-expected mortality rates were compared on three measures of accreditation survey performance. These comparisons were made for three mortality groups: overall, stroke, and acute heart disease. No statistically significant (p = 0.05) differences were found in survey performance for any of the mortality groups compared. This lack of association between mortality and hospital quality, as measured by accreditation performance, reinforces concern about the use of mortality rates as measures of quality for public policy or patient decision-making purposes.
1987年，医疗保健财务管理局（HCFA）汇编并发布了1986年美国5971家医院医疗保险住院患者的死亡率信息。1986年，医疗保健组织认证联合委员会对其中1628家机构进行了全面的三年期认证调查。本报告探讨了1986年医疗保险死亡率与医院质量之间的关系，医院质量通过认证调查表现来衡量。将死亡率高于预期和低于预期的医院在认证调查表现的三项指标上进行比较。这些比较针对三个死亡率组别进行：总体、中风和急性心脏病。在比较的任何死亡率组别中，均未发现调查表现存在统计学上的显著差异（p = 0.05）。以认证表现衡量的死亡率与医院质量之间缺乏关联，这进一步加剧了人们对将死亡率用作公共政策或患者决策质量衡量指标的担忧。
