Key result
Risk-adjusted hospital outcomes improved steadily over 7.5 years despite worsening case mix, with a final observed-to-expected ratio for inpatient mortality of 0.79 (95% CI, 0.73-0.84).
Why the study?
Interpreting rehospitalization rates without accounting for US health care delivery changes and comprehensive electronic medical record data yields a limited assessment of care quality.
Population
679 831 adult patients across 1 384 025 hospitalizations in 21 hospitals
Comparison
Hospitalization type, comorbidity burden, acute physiology score, and care directives
Design
Cohort study
Follow-up
30 days
Authors
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May inform quality initiatives in integrated systems; leaves open generalizability and causal factors.
Cohort (n=679,831)
Yes
Effect estimate: O/E ratio 0.79 (95% CI 0.73-0.84)
Risk-adjusted hospital outcomes, including mortality and rehospitalization, improved over a 7.5-year period in an integrated health care system despite an increasing patient illness burden.
Escobar et al. (2019) conducted a cohort in Hospitalization (all diagnoses) (n=679,831). Time period (final month vs first month) vs. First month of study was evaluated on Risk-adjusted inpatient mortality (O/E ratio 0.79, 95% CI 0.73-0.84). Risk-adjusted hospital outcomes improved steadily over 7.5 years despite worsening case mix, with a final observed-to-expected ratio for inpatient mortality of 0.79 (95% CI, 0.73-0.84).
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