Abstract
Objectives: To examine the development in process quality related to stroke, heart failure and ulcer (bleeding and perforated) between accredited and non-accredited hospitals.
Method: All Danish hospitals which treated patients with stroke or heart failure during 2004-2008 or treated patients with bleeding or perforated ulcer during 2006-2008 were included. The hospitals were categorized in two groups, non-accredited hospitals (i.e., hospitals not participating in an accreditation program) and hospitals accredited either by Joint Commission International or Health Quality Service. Individual-level processes of care data was obtained from national population-based registries. The accredited and non-accredited hospitals were compared using 20 processes of care indicators reflecting hospital compliance with national clinical guidelines. The 20 indicators included seven indicators for stroke, seven indicators for heart failure, three indicators for bleeding ulcer and three indicators for perforated ulcer. The primary outcome was the composite fulfilment of process indicators. The secondary outcome was all-or-none, defined as the proportion of patients receiving 100 % of the recommended processes of care. Two-sided t tests were used for statistical analysis with p < 0.05 as a significance level.
Results: A total of 70120 patients from 24 hospitals were included. Analysis of the composite fulfilment of process indicators showed no differences at baseline between accredited and non-accredited hospitals for neither stroke (P = 0.55), heart failure (P=0.88), bleeding ulcer (P=0.67) and perforated ulcer (P =0.16). Non-accredited hospitals performed better in the study period regarding stroke (P<0.01) (table 1), whereas no clear differences were found for heart failure, bleeding ulcer or perforated ulcer. Non-accredited hospitals had statically larger improvement in all-or-none indicator related to stroke compared with accredited hospitals (P = 0.04). No difference in heart failure, bleeding ulcer or perforated ulcer was found.
Conclusions: This study does not support the hypothesis that accredited hospitals provide better process of care quality.
Method: All Danish hospitals which treated patients with stroke or heart failure during 2004-2008 or treated patients with bleeding or perforated ulcer during 2006-2008 were included. The hospitals were categorized in two groups, non-accredited hospitals (i.e., hospitals not participating in an accreditation program) and hospitals accredited either by Joint Commission International or Health Quality Service. Individual-level processes of care data was obtained from national population-based registries. The accredited and non-accredited hospitals were compared using 20 processes of care indicators reflecting hospital compliance with national clinical guidelines. The 20 indicators included seven indicators for stroke, seven indicators for heart failure, three indicators for bleeding ulcer and three indicators for perforated ulcer. The primary outcome was the composite fulfilment of process indicators. The secondary outcome was all-or-none, defined as the proportion of patients receiving 100 % of the recommended processes of care. Two-sided t tests were used for statistical analysis with p < 0.05 as a significance level.
Results: A total of 70120 patients from 24 hospitals were included. Analysis of the composite fulfilment of process indicators showed no differences at baseline between accredited and non-accredited hospitals for neither stroke (P = 0.55), heart failure (P=0.88), bleeding ulcer (P=0.67) and perforated ulcer (P =0.16). Non-accredited hospitals performed better in the study period regarding stroke (P<0.01) (table 1), whereas no clear differences were found for heart failure, bleeding ulcer or perforated ulcer. Non-accredited hospitals had statically larger improvement in all-or-none indicator related to stroke compared with accredited hospitals (P = 0.04). No difference in heart failure, bleeding ulcer or perforated ulcer was found.
Conclusions: This study does not support the hypothesis that accredited hospitals provide better process of care quality.
| Bidragets oversatte titel | Akkrediterring og udvikling i proces kvalitet: Et nationalt studie |
|---|---|
| Originalsprog | Engelsk |
| Publikationsdato | 6. okt. 2014 |
| Antal sider | 1 |
| Status | Udgivet - 6. okt. 2014 |
| Begivenhed | 31st International Conference on Quality and Safety along the Health and Social Care Continuum - Windsor Barra Conference Centre, Rio de Janeiro, Brasilien Varighed: 5. okt. 2014 → 8. okt. 2014 |
Konference
| Konference | 31st International Conference on Quality and Safety along the Health and Social Care Continuum |
|---|---|
| Lokation | Windsor Barra Conference Centre |
| Land/Område | Brasilien |
| By | Rio de Janeiro |
| Periode | 05/10/2014 → 08/10/2014 |
Emneord
- Akkreditering
- Proces kvalitet