Association Between a Hospital's Quality Performance for In‐Hospital Cardiac Arrest and Common Medical Conditions

1University of Michigan, Ann Arbor, MI
2University of Michigan, Ann Arbor, MI
3Yale University, New Haven, CT
4Saint Luke's Mid‐America Heart and Vascular Institute, Kansas City, MO
5Saint Luke's Mid‐America Heart and Vascular Institute, Kansas City, MO
6Saint Luke's Mid‐America Heart and Vascular Institute, Kansas City, MO

Meeting: Hospital Medicine 2013, May 16-19, National Harbor, Md.

Abstract number: 110

Background:

Public reporting on hospital quality has been widely adopted for a few medical conditions. Broadening the scope of these efforts to include cardiac arrest is now being considered. Given growing evidence that hospital organization and culture can have hospital‐wide effects on quality of care, it is unknown if a measure of inpatient survival after cardiac arrest would be redundant.

Methods:

Using data between 2007 and 2010 from a large, national in‐hospital cardiac arrest registry, we calculated risk‐standardized in‐hospital survival rates for cardiac arrest at each hospital. We then obtained risk‐standardized 30‐day mortality rates for acute myocardial infarction (AMI), heart failure (HF), and pneumonia from Hospital Compare for the same period. The relationship between a hospital's performance on cardiac arrest and these other medical conditions was assessed using weighted Pearson correlation coefficients.

Results:

Among 26,270 patients with in‐hospital cardiac arrest at 130 hospitals, survival rates varied across hospitals, with a median risk‐standardized hospital survival rate of 22.1% and an interquartile range (IQR) of 19.7%–24.2%. Similarly, there was site‐level variation in hospital outcomes for common medical conditions, with median risk‐standardized 30‐day mortality rates at hospitals of 15.4% (IQR, 14.4%–16.6%) for AMI, 11.3% (IQR, 10.3%–12.3%) for HF, and 11.9% (IQR, 10.7%–13.0%) for pneumonia. There were no significant correlations between a hospital's outcomes for its cardiac arrest patients and its patients admitted for AMI (correlation of −0.12; P = 0.16), HF (correlation of −0.05; P = 0.57), or pneumonia (correlation of −0.15, P = 0.10).

Conclusions:

Hospitals that performed better on publicly reported outcomes for 3 common medical conditions did not necessarily have better cardiac arrest survival rates. Public reporting on cardiac arrest outcomes could provide new information about hospital quality.

Note: The authors are submitting this abstract for the American Heart Association's Get With the Guidelines®‐Resuscitation (formerly the National Registry of Cardiopulmonary Resuscitation) Investigators.

To cite this abstract:

Chen L, Nallamothu B, Krumholz H, Spertus J, Tang F, Chan P. Association Between a Hospital's Quality Performance for In‐Hospital Cardiac Arrest and Common Medical Conditions. Abstract published at Hospital Medicine 2013, May 16-19, National Harbor, Md. Abstract 110. Journal of Hospital Medicine. 2013; 8 (suppl 2). https://www.shmabstracts.com/abstract/association-between-a-hospitals-quality-performance-for-inhospital-cardiac-arrest-and-common-medical-conditions/. Accessed November 18, 2019.

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