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Efforts to improve hospital care

(SACRAMENTO, Calif.) -- In recent years, American hospitals have made significant improvements on standardized, evidence-based measures of clinical performance for several medical conditions, including heart attacks, heart failure, and pneumonia. But an editorial, published in the July 21 issue of the New England Journal of Medicine, says it's not clear how much effect these improvements in patient care have had on public health, especially in reducing morbidity and mortality. The editorial, authored by Patrick S. Romano, professor of general medicine at UC Davis School of Medicine and Medical Center, is published along with two new quality-of-care studies.

"Evaluating how hospitals deliver medical care does standardize practices and improve care," says Romano. "For example, hospitals are now more likely to give aspirin and beta blockers to heart attack patients, to evaluate heart failure patients appropriately, to provide complete instructions when patients go home, and to counsel smokers to quit. But we do not yet have evidence that these improvements are reducing morbidity and mortality from heart disease, heart failure and pneumonia."

In the editorial, Romano analyzes two studies that used standardized, evidence-based measure to evaluate and improve hospitals' quality of care. One study, from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), describes results from a program in which hospitals seeking accreditation were required to collect and submit data on clinical performance on 18 measures for acute myocardial infarction, heart failure and pneumonia. The other, from the Centers for Medicare and Medicaid Services (CMS), reports on several of the same measures as the JCAHO study.

"These studies didn't find any reduction in early deaths from heart attacks, deaths among newborns, or injuries during delivery," said Romano. "Perhaps the benefits of improving care in hospitals aren't visible until several months or y
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Contact: Carole Gan
carole.gan@ucdmc.ucdavis.edu
916-734-9047
University of California, Davis - Health System
20-Jul-2005


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