Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-24T17:36:54.140Z Has data issue: false hasContentIssue false
  • English
  • Français

What Do Mortality Studies Reveal about Hospital Volume, Teaching Status, And Ownership?

Published online by Cambridge University Press:  10 March 2009

Joyce V. Kelly
Joyce V. Kelly
Affiliation:
Association of American Medical Colleges
Get access Rights & Permissions [Opens in a new window]

Abstract

Numerous recent studies use risk-adjusted patient mortality rates to measure hospital performance, focusing on such hospital characteristics as volume of patients, teaching status, and ownership. This article summarizes the empirical findings of these studies, critiques their methods and models, and offers recommendations for overcoming several obstacles to meaningful correlation of patient outcomes and provider performance.

Type
Special Section: Measuring Health Care Effectiveness: Use of Large Data Bases for Technology and Quality Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 6 , Issue 2 , January 1990 , pp. 239 - 252
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Blumberg, M. S.Comments on HCFA hospital death rate statistical outliers. Health Services Research, 1987, 21, 715–39.Google ScholarPubMed
2DesHarnais, S. I., Chesney, J. D., Wroblewski, R. T. et al. , The Risk-Adjusted Mortality Index: A new measure of hospital performance. Medical Care, 1988, 26, 1129–48.CrossRefGoogle ScholarPubMed
3Doyle, M. D. Teaching effects on the outcomes and costs of patient care. Ph.D. dissertation, Vanderbilt University, 05 1989.Google Scholar
4Dubois, R. W., Rogers, W. H., Moxley, J. H., & Draper, D.Hospital inpatient mortality: Is it a predictor of quality medical care? New England Journal of Medicine, 1987, 317, 1674–80.CrossRefGoogle Scholar
5Fink, A., Yano, E. M., & Brook, R. H.The condition of the literature on differences in hospital mortality. Medical Care, 1989, 27, 315–36.CrossRefGoogle ScholarPubMed
6Hannan, E. L., O'Donnell, J. F. et al. , Investigation of the relationship between volume and mortality for surgical procedures performed in New York State hospitals. Journal of the American Medical Association, 1989, 262, 503–10.Google Scholar
7Hughes, R. G., Garnick, D. W., Luft, H. S. et al. , Hospital volume and patient outcomes: The case of hip fracture patients. Medical Care, 1988, 26, 1057–67.Google Scholar
8Kelly, J. V., & Hellinger, F. J.Physician and hospital factors associated with mortality of surgical patients. Medical Care, 1986, 24, 785–800.CrossRefGoogle ScholarPubMed
9Kelly, J. V., & Hellinger, F. J.Heart disease and hospital deaths: An empirical study. Health Services Research, 1987, 22, 369–95.Google ScholarPubMed
10Kelly, J. V. Deaths in teaching and nonteaching hospitals: Quality of care and severity of illness differences. NCHSR Working Paper. Rockville, MD: U.S. Department of Health and Human Resources, NCHSR, 06 1988.Google Scholar
11Kelly, J. V. & Keyes, M. M.Medical practice patterns, patient outcomes, and quality of care assessment: A selected annotated bibliography. Washington, DC: American Association of American Medical Colleges, 09 1989.Google Scholar
12Luft, H. S., Hunt, S. S., & Maerki, S. C.The volume-outcome relationship: Practice-makes- perfect or selective-referral patterns? Health Services Research, 1987, 22, 157–82.Google ScholarPubMed
13Luft, H. S., ed. Hospital volume, patient volume, and patient outcomes: Assessing the evidence. Ann Arbor, MI: Health Administration Press, in press.Google Scholar
14Medicare hospital mortality information 1987. Washington, DC: U.S. Department of Health and Human Services, HCFA, 1988.Google Scholar
15Riley, G., & Lubitz, J.Outcomes of surgery among the Medicare aged: Surgical volume and mortality. Health Care Financing Review, 1985, 7(FalI), 37–47.Google ScholarPubMed
16Roper, W. L., Winkenwerder, W., Hackbarth, G. M., & Krakauer, H.Effectiveness in health care: An initiative to evaluate and improve medical practice. New England Journal of Medicine, 1988, 319, 1197–202.CrossRefGoogle ScholarPubMed