May 21, 2007Medical Care
Quality of Care in Hospitals with a High Percent of Medicaid Patients
Key result
High Medicaid nonteaching hospitals had significantly lower adherence to quality indicators than other hospitals, such as prescribing beta-blockers at discharge for MI (83% vs. 90%, P<0.0001).
Why the study?
Do hospitals with a high percentage of Medicaid patients provide a different quality of care than other hospitals?
Population
Acute care hospitals participating in the first Hospital Compare public report and the 2004 American…
Comparison
High Medicaid hospitals vs Other hospitals (not high Medicaid)
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
High Medicaid nonteaching hospitals show lower MI/CHF quality adherence; leaves open whether targeted resources can close gaps.
Study Design
Type
Cross-Sectional (n=2,874)
Multicenter
Yes
Structured PICO
Do hospitals with a high percentage of Medicaid patients provide a different quality of care than other hospitals?
P
Population
Acute care hospitals participating in the first Hospital Compare public report (released November 2004) and the 2004 American Hospital Association hospital survey, including 2874 nonteaching hospitals.
I
Intervention
High Medicaid hospitals (serving 1 standard deviation above the national mean percentage of Medicaid patients)
C
Comparator
Other hospitals (not high Medicaid)
O
Outcome
Percent compliance with 10 processes of care for 3 conditions: myocardial infarction, congestive heart failure, and community-acquired pneumonia
Main Result
p-value: p=<0.01
Nonteaching hospitals treating a high percentage of Medicaid patients demonstrated lower adherence to quality of care indicators for conditions including MI and CHF compared to other nonteaching hospitals.
Cite This Study
Goldman et al. (2007) conducted a cross-sectional in Myocardial infarction, congestive heart failure, and community-acquired pneumonia (n=2,874). High Medicaid hospitals (serving 1 SD above the national mean percentage of Medicaid patients) vs. Other hospitals was evaluated on Percent compliance with 10 processes of care for myocardial infarction, congestive heart failure, and community-acquired pneumonia (p=<0.01). High Medicaid nonteaching hospitals had significantly lower adherence to quality indicators than other hospitals, such as prescribing beta-blockers at discharge for MI (83% vs. 90%, P<0.0001).