Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Effectiveness of Nonpublic Report Cards for Reducing Trauma Mortality

Effectiveness of Nonpublic Report Cards for Reducing Trauma Mortality ImportanceAn Institute of Medicine report on patient safety that cited medical errors as the 8th leading cause of death fueled demand to use quality measurement as a catalyst for improving health care quality. ObjectiveTo determine whether providing hospitals with benchmarking information on their risk-adjusted trauma mortality outcomes will decrease mortality in trauma patients. Design, Setting, and ParticipantsHospitals were provided confidential reports of their trauma risk–adjusted mortality rates using data from the National Trauma Data Bank. Regression discontinuity modeling was used to examine the impact of nonpublic reporting on in-hospital mortality in a cohort of 326 206 trauma patients admitted to 44 hospitals, controlling for injury severity, patient case mix, hospital effects, and preexisting time trends. Main Outcomes and MeasuresIn-hospital mortality rates. ResultsPerformance benchmarking was not significantly associated with lower in-hospital mortality (adjusted odds ratio [AOR], 0.89; 95% CI, 0.68-1.16; P = .39). Similar results were obtained in secondary analyses after stratifying patients by mechanism of trauma: blunt trauma (AOR, 0.91; 95% CI, 0.69-1.20; P = .51) and penetrating trauma (AOR, 0.75; 95% CI, 0.44-1.28; P = .29). We also did not find a significant association between nonpublic reporting and in-hospital mortality in either low-risk (AOR, 0.84; 95% CI, 0.57-1.25; P = .40) or high-risk (AOR, 0.88; 95% CI, 0.67-1.17; P = .38) patients. Conclusions and RelevanceNonpublic reporting of hospital risk-adjusted mortality rates does not lead to improved trauma mortality outcomes. The findings of this study may prove useful to the American College of Surgeons as it moves ahead to further develop and expand its national trauma benchmarking program. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Effectiveness of Nonpublic Report Cards for Reducing Trauma Mortality

Download PDF
7 pages
Read Article

Loading next page...
 
/lp/american-medical-association/effectiveness-of-nonpublic-report-cards-for-reducing-trauma-mortality-EhRywWBW52
Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/jamasurg.2013.3977
pmid
24336907
Publisher site
See Article on Publisher Site

Abstract

ImportanceAn Institute of Medicine report on patient safety that cited medical errors as the 8th leading cause of death fueled demand to use quality measurement as a catalyst for improving health care quality. ObjectiveTo determine whether providing hospitals with benchmarking information on their risk-adjusted trauma mortality outcomes will decrease mortality in trauma patients. Design, Setting, and ParticipantsHospitals were provided confidential reports of their trauma risk–adjusted mortality rates using data from the National Trauma Data Bank. Regression discontinuity modeling was used to examine the impact of nonpublic reporting on in-hospital mortality in a cohort of 326 206 trauma patients admitted to 44 hospitals, controlling for injury severity, patient case mix, hospital effects, and preexisting time trends. Main Outcomes and MeasuresIn-hospital mortality rates. ResultsPerformance benchmarking was not significantly associated with lower in-hospital mortality (adjusted odds ratio [AOR], 0.89; 95% CI, 0.68-1.16; P = .39). Similar results were obtained in secondary analyses after stratifying patients by mechanism of trauma: blunt trauma (AOR, 0.91; 95% CI, 0.69-1.20; P = .51) and penetrating trauma (AOR, 0.75; 95% CI, 0.44-1.28; P = .29). We also did not find a significant association between nonpublic reporting and in-hospital mortality in either low-risk (AOR, 0.84; 95% CI, 0.57-1.25; P = .40) or high-risk (AOR, 0.88; 95% CI, 0.67-1.17; P = .38) patients. Conclusions and RelevanceNonpublic reporting of hospital risk-adjusted mortality rates does not lead to improved trauma mortality outcomes. The findings of this study may prove useful to the American College of Surgeons as it moves ahead to further develop and expand its national trauma benchmarking program.

Journal

JAMA Surgery – American Medical Association

Published: Feb 1, 2014

References

  • The Department of Veterans Affairs’ NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care.
    Khuri, SF; Daley, J; Henderson, W
  • Improving the outcomes of coronary artery bypass surgery in New York State.
    Hannan, EL; Kilburn, H; Racz, M; Shields, E; Chassin, MR
  • A regional intervention to improve the hospital mortality associated with coronary artery bypass graft surgery.
    O’Connor, GT; Plume, SK; Olmstead, EM
  • Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals.
    Hall, BL; Hamilton, BH; Richards, K; Bilimoria, KY; Cohen, ME; Ko, CY
  • Public reporting of cardiac surgery performance, part 1: history, rationale, consequences.
    Shahian, DM; Edwards, FH; Jacobs, JP
  • Medicare’s public reporting initiative on hospital quality had modest or no impact on mortality from three key conditions.
    Ryan, AM; Nallamothu, BK; Dimick, JB
  • Linking performance with payment: implementing the Physician Value-Based Payment Modifier.
    VanLare, JM; Blum, JD; Conway, PH
  • The Survival Measurement and Reporting Trial for Trauma (SMARTT): background and study design.
    Glance, LG; Osler, TM; Dick, AW; Mukamel, DB; Meredith, W
  • A national evaluation of the effect of trauma-center care on mortality.
    MacKenzie, EJ; Rivara, FP; Jurkovich, GJ
  • Moving beyond personnel and process: a case for incorporating outcome measures in the trauma center designation process.
    Shafi, S; Friese, R; Gentilello, LM
  • The effect of preexisting conditions on hospital quality measurement for injured patients.
    Glance, LG; Dick, AW; Mukamel, DB; Meredith, W; Osler, TM
  • A trauma mortality prediction model based on the anatomic injury scale.
    Osler, T; Glance, L; Buzas, JS; Mukamel, D; Wagner, J; Dick, A
  • TMPM-ICD9: a trauma mortality prediction model based on ICD-9-CM codes.
    Glance, LG; Osler, TM; Mukamel, DB; Meredith, W; Wagner, J; Dick, AW
  • The impact of minimum legal drinking age laws on alcohol consumption, smoking, and marijuana use: evidence from a regression discontinuity design using exact date of birth.
    Yörük, BK; Yörük, CE
  • Multiple imputation of missing blood pressure covariates in survival analysis.
    van Buuren, S; Boshuizen, HC; Knook, DL
    Bookmark
  • Regression using fractional polynomials of continuous covariates: parsimonious parametric modeling.
    Royston, P; Altman, DG
  • Comparing risk-adjustment methods for provider profiling.
    DeLong, ER; Peterson, ED; DeLong, DM; Muhlbaier, LH; Hackett, S; Mark, DB
    Bookmark
  • A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity.
    White, H
  • The NSQIP: a new frontier in surgery.
    Khuri, SF
    Bookmark
  • Pay for performance, quality of care, and outcomes in acute myocardial infarction.
    Glickman, SW; Ou, FS; DeLong, ER
  • Effects of the Premier Hospital Quality Incentive Demonstration on Medicare patient mortality and cost.
    Ryan, AM
    Bookmark
  • The comparative assessment and improvement of quality of surgical care in the Department of Veterans Affairs.
    Khuri, SF; Daley, J; Henderson, WG
  • Adherence to surgical care improvement project measures and the association with postoperative infections.
    Stulberg, JJ; Delaney, CP; Neuhauser, DV; Aron, DC; Fu, P; Koroukian, SM
  • Public reporting on hospital process improvements is linked to better patient outcomes.
    Werner, RM; Bradlow, ET
  • The Trauma Quality Improvement Program of the American College of Surgeons Committee on Trauma.
    Shafi, S; Nathens, AB; Cryer, HG
    Bookmark
  • Health-care reforms in the USA and England: areas for useful learning.
    Blumenthal, D; Dixon, J

You’re reading a free preview. Subscribe to read the entire article.

Try 2 weeks free now

DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

or browse the journals available

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$499/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

Sign up
for free
Start 14 day
Free Trial