The performance of US hospitals as reflected in risk-standardized 30-day mortality and readmission rates for medicare beneficiaries with pneumonia

摘要: BACKGROUND: Pneumonia is a leading cause of hospitalization and death in the elderly, remains subject both local national quality improvement efforts. OBJECTIVE: To describe patterns hospital regional performance outcomes elderly patients with pneumonia. DESIGN: Cross-sectional study using outpatient Medicare claims between 2006 2009. SETTING: A total 4,813 nonfederal acute care hospitals United States its organized territories. PATIENTS: Hospitalized fee-for-service beneficiaries age 65 years older who received principal diagnosis pneumonia. INTERVENTION: None. MEASUREMENTS: Hospital level risk-standardized 30-day mortality readmission rates. RESULTS: Of 1,118,583 included analysis 129,444 (11.6%) died within 30 days admission. The median (Q1, Q3) rate for pneumonia was 11.1% (10.0%, 12.3%), despite controlling differences case mix, ranged from 6.7% to 20.9%. Among 1,161,817 212,638 (18.3%) were readmitted discharge. 18.2% (17.2%, 19.2%) 13.6% 26.7%. Risk-standardized rates varied across referral regions high 14.9% low 8.7%. 22.2% 15%. CONCLUSIONS: Risk-standardized and, lesser extent, vary substantially may present opportunities improvement, especially at performing institutions areas. Journal Hospital Medicine 2010. © 2010 Society Medicine.