Does Level of Hospital Matter? A Study of Mortality of Acute Myocardial Infarction Patients in Shanxi, China. (March 2018)

• Record Type: Journal Article
• Authors: Cai, Miao; Liu, Echu; Tao, Hongbing; Qian, Zhengmin; Lin, Xiaojun; Cheng, Zhaohui
• Is Part Of: American journal of medical quality. Volume 33:Number 2(2018)
• Page Start: 185
• Page End: 192
• Publication Date: 2018-03
• Subjects: level of hospital -- risk-standardized mortality rate -- Charlson comorbidity index -- Elixhauser index; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860617708608
• Languages: English
• ISSNs: 1062-8606

Abstract

This study compares risk-standardized mortality rates (RSMRs) of patients with acute myocardial infarction among tertiary A (typically, advanced urban hospitals with more than 800 beds), tertiary B (urban hospitals with more than 500 beds), and secondary A hospitals (rural and urban hospitals with less than 500 beds) in Shanxi, China. In all, 43 500 acute myocardial infarction inpatient records from 93 hospitals were included. Hierarchical logistic regression was used to estimate RSMRs, and Dunn's post hoc test was used to make pairwise comparisons of RSMR between hospital levels. It was found that the median RSMRs of secondary A hospitals were significantly lower than those of tertiary A and tertiary B hospitals (at 1% and 10% significance level, respectively), while there was no significant difference between the median RSMRs in tertiary A and tertiary B hospitals. The reasons for significant disparity in quality of care among different hospital levels requires further exploration.