Care quality linked to patient population, illness severity

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Do hospital resources (or a lack thereof) affect the quality of care received?

That's the question Cincinnati Children's Hospital Medical Center researchers set out to answer in a recent study of safety-nets, non-safety-nets and children's hospitals.

They found patient population, rather than a hospital's resources (defined as Medicaid burden), best predicts quality outcomes for pediatric patients, according to the study in this month's Pediatrics.

The researchers analyzed non-newborn pediatric inpatient discharge records for 1,050 hospitals in 2009 that potentially experienced at least one pediatric quality indicator event, noted HealthDay.

According their findings, inpatient safety was more associated with patients' severity of illness and presence of chronic conditions than with scarce resources or high Medicaid burden.

The study adds to evidence that despite financial burdens of treating large numbers of uninsured and low-income patients, quality of care doesn't suffer at safety-net hospitals. For instance, a study published in the August Health Affairs found comparable mortality and readmission rates and identical heart failure mortality rates for safety-nets and non-safety-net hospitals for acute myocardial infarction, heart failure or pneumonia patients.

Given such findings, the Cincinnati Children's researchers called for stronger risk adjustment mechanisms when incentivizing quality and comparing hospitals, according to the study.

For example, although an April 2012 analysis found that the more than 1,200 federally funded community health centers performed poorly on fundamental care quality measures, the quality report cards failed to account for the fact that some health centers treat sicker patients.

For more:
- check out the study abstract
- here's the HealthDay article

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