Massachusetts General Hospital, Boston, MA.
Harvard University, Boston, MA.
Am J Med Qual. 2020 Mar/Apr;35(2):110-116. doi: 10.1177/1062860619857028. Epub 2019 Jun 21.
A variety of hospital characteristics, including teaching status, ownership, location, and size, have been shown to be associated with quality measure performance. The association of hospital characteristics, including teaching intensity, with performance on the Centers for Medicare & Medicaid Services (CMS) SEP-1 sepsis measure has not been well studied. Utilizing a statewide, all-payer database and the CMS Hospital Compare database, this study investigated the association of various hospital characteristics with early SEP-1 performance in 48 acute hospitals in Massachusetts. Hospital teaching intensity and Magnet designation did not have a statistically significant association with SEP-1 performance in multivariable linear modeling. However, SEP-1 performance was higher in smaller, for-profit hospitals with higher case mix index. This finding suggests that emergency department activity, hospital ownership, and patient complexity should be studied further across a larger geographic spectrum and longitudinally as hospitals implement efforts to reduce morbidity associated with sepsis.
多种医院特征,包括教学状态、所有权、位置和规模,已被证明与质量衡量标准的表现有关。医院特征,包括教学强度,与医疗保险和医疗补助服务中心(CMS)SEP-1 败血症措施的表现之间的关联尚未得到很好的研究。本研究利用全州、所有支付者数据库和 CMS 医院比较数据库,调查了马萨诸塞州 48 家急性医院的各种医院特征与 SEP-1 早期表现之间的关联。在多变量线性模型中,医院教学强度和磁铁指定与 SEP-1 表现没有统计学上的显著关联。然而,SEP-1 的表现更高的是规模较小、盈利性较高、病例组合指数较高的医院。这一发现表明,应进一步在更大的地理范围和纵向范围内研究急诊科活动、医院所有权和患者复杂性,因为医院正在努力减少与败血症相关的发病率。