Quality of care in hospitals varies among regions and within individual hospitals

Boston, MA Ashish Jha, assistant professor of health policy and management at the Harvard School of Public Health and colleagues from Brigham and Women's Hospital and the Boston Veterans Affairs Healthcare System, have for the first time assessed the quality of care in U.S. hospitals. Using information gathered from the Hospital Quality Alliance, the first national initiative to report data on hospitals' performance, they found that hospital care varies across medical conditions, and although hospitals seem to be improving, many hospitals fail to provide life saving care consistently to their patients. Further, they found tremendous regional variation in the quality of care across the country: Boston provided the best care in the nation for patients with heart attacks or congestive heart failure but did not do as well in pneumonia care. The findings appear in the July 21, 2005 issue of the New England Journal of Medicine. An accompanying editorial also appears in this issue of the journal.

Until now, there has been no national database on the quality of care at U.S. hospitals. The Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations, the American Hospital Association and the American Association for Retired Persons joined forces to form the Hospital Quality Alliance (HQA) to gather data on the quality of care provided by U.S. hospitals.

Using HQA data from 3,558 hospitals, the researchers studied 10 quality indicators, tests or treatments that have been shown to reduce death or improve health, for three important medical conditions: acute myocardial infarction, congestive heart failure and pneumonia. They assessed how well hospitals performed and found that for six of the ten indicators, patients failed to receive needed care about 10 to 20 percent of the time. For the other four indicators, performance was much worse. They also examined hospital characteristics that were linked with

Contact: Kevin C. Myron
Harvard School of Public Health

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