Bradbury R C, Golec J H, Stearns F E, Steen P M
Master of Health Administration Program, Graduate School of Management, Clark University, Worcester, MA.
J Soc Health Syst. 1993;4(1):48-67.
A 1986 Pennsylvania law requires the public disclosure of hospital mortality and morbidity rates. This study of hospital admissions in 1989 and 1990 examines the variation in these health-outcome indicators for the 10 most frequently occurring DRGs in the adult medical service in a sample of 20 Pennsylvania hospitals. These mortality and morbidity rates are adjusted for admission severity, DRG, age, and sex, using a logistic regression model. The null hypothesis of no significant variation among hospitals is rejected by the statistically significant (p < 0.01) results of a likelihood ratio test on the hospital variables in logit models for both mortality and morbidity. Test results also show that 4 (20 percent) of 20 hospitals have statistically significant (p < 0.05) adjusted mortality rates, and 4 (20 percent) of 20 hospitals have significant morbidity rates. Such information may impact hospital management practices in a variety of ways.
1986年宾夕法尼亚州的一项法律要求公开医院的死亡率和发病率。这项对1989年和1990年医院入院情况的研究，考察了宾夕法尼亚州20家医院样本中成人医疗服务中10种最常见诊断相关分组（DRG）的这些健康结果指标的差异。使用逻辑回归模型，对这些死亡率和发病率进行了入院严重程度、DRG、年龄和性别的调整。在死亡率和发病率的logit模型中，对医院变量进行似然比检验，结果具有统计学显著性（p < 0.01），从而拒绝了医院之间无显著差异的零假设。测试结果还表明，20家医院中有4家（20%）的调整后死亡率具有统计学显著性（p < 0.05），20家医院中有4家（20%）的发病率具有显著性。此类信息可能会以多种方式影响医院的管理实践。
