Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly

Critical Care Medicine
Michael W SjodingColin R Cooke

Abstract

Quality of care for patients admitted with pneumonia varies across hospitals, but causes of this variation are poorly understood. Whether hospitals with high ICU utilization for patients with pneumonia provide better quality care is unknown. We sought to investigate the relationship between a hospital's ICU admission rate for elderly patients with pneumonia and the quality of care it provided to patients with pneumonia. Retrospective cohort study. Two thousand eight hundred twelve U.S. hospitals. Elderly (age≥65 years) fee-for-service Medicare beneficiaries with either a (1) principal diagnosis of pneumonia or (2) principal diagnosis of sepsis or respiratory failure and secondary diagnosis of pneumonia in 2008. None. We grouped hospitals into quintiles based on ICU admission rates for pneumonia. We compared rates of failure to deliver pneumonia processes of care (calculated as 100-adherence rate), 30-day mortality, hospital readmissions, and Medicare spending across hospital quintile. After controlling for other hospital characteristics, hospitals in the highest quintile more often failed to deliver pneumonia process measures, including appropriate initial antibiotics (13.0% vs 10.7%; p<0.001), and pneumococcal vaccination (15....Continue Reading

References

Jan 1, 1992·Statistical Methods in Medical Research·J M Neuhaus
Dec 24, 1997·JAMA : the Journal of the American Medical Association·T P MeehanJ M Fine
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Oct 4, 2000·JAMA : the Journal of the American Medical Association·S F JencksD R Arday
Jul 24, 2004·American Journal of Respiratory and Critical Care Medicine·Theodore J Iwashyna
Jul 22, 2005·The New England Journal of Medicine·Ashish K JhaArnold M Epstein
Feb 24, 2006·Annals of Internal Medicine·Peter K LindenauerDale W Bratzler
Feb 6, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lionel A MandellUNKNOWN American Thoracic Society
Jul 29, 2010·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Peter K LindenauerHarlan M Krumholz
Aug 21, 2010·Health Services Research·Justin B DimickJohn D Birkmeyer
Feb 18, 2011·JAMA : the Journal of the American Medical Association·Karen E JoyntAshish K Jha
May 9, 2012·Critical Care Medicine·Hayley B GershengornHannah Wunsch
Apr 23, 2013·Medical Care·Stephanie K MuellerLeroi S Hicks

❮ Previous
Next ❯

Citations

May 16, 2015·Critical Care Medicine·José Artur Paiva, José Manuel Pereira
Apr 20, 2016·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Vineet ChopraPeter K Lindenauer
Sep 2, 2016·Current Opinion in Critical Care·Charles Feldman, Ronald Anderson
Jan 4, 2020·Annals of the American Thoracic Society·Laura J SpeceDavid H Au
Apr 9, 2016·Annals of the American Thoracic Society·Ian J BarbashJeremy M Kahn
Dec 28, 2019·Critical Care : the Official Journal of the Critical Care Forum·Marlies Ostermann, Jean-Louis Vincent
Oct 21, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Lavi Oud

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Bacterial Pneumonia

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Bacterial Pneumonia (ASM)

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

© 2021 Meta ULC. All rights reserved