纽约市公立医院与私立医院在特定病症方面的死亡率差异。
Mortality differences between New York City municipal and voluntary hospitals, for selected conditions.
作者信息
Shapiro M F, Park R E, Keesey J, Brook R H
机构信息
RAND Corporation, Los Angeles, CA.
出版信息
Am J Public Health. 1993 Jul;83(7):1024-6. doi: 10.2105/ajph.83.7.1024.
To determine if mortality differences between municipal and voluntary hospitals in New York City persist after adjustment for computerized administrative data (age, sex, principal diagnosis, and secondary diagnosis), six conditions in those hospitals from 1984 through 1987 were studied. Unadjusted mortality was significantly higher in municipal hospitals for myocardial infarction, stroke, and head trauma, and lower for congestive heart failure and pneumonia. Adjustment using administrative data eliminated differences for myocardial infarction, congestive heart failure, and pneumonia, but not for stroke and head trauma. We conclude that adjustment using administrative data eliminates some but not all mortality differences between municipal and voluntary hospitals. Medical record review is needed to determine why these differences persist.
为了确定在对计算机化管理数据（年龄、性别、主要诊断和次要诊断）进行调整后，纽约市公立医院和志愿医院之间的死亡率差异是否依然存在，我们研究了这些医院在1984年至1987年期间的六种病症。未经调整时，公立医院中心肌梗死、中风和头部创伤的死亡率显著更高，而充血性心力衰竭和肺炎的死亡率则更低。使用管理数据进行调整消除了心肌梗死、充血性心力衰竭和肺炎方面的差异，但中风和头部创伤方面的差异依然存在。我们得出结论，使用管理数据进行调整消除了公立医院和志愿医院之间部分而非全部的死亡率差异。需要对病历进行审查以确定这些差异为何依然存在。
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