title: Lack of relationship between the Cleveland Health Quality Choice project and decreased inpatient mortality in Cleveland.
abstract: The Cleveland Health Quality Choice (CHQC) project was previously suggested to have been responsible for declines in inpatient mortality in Cleveland hospitals during the first years of the project (1992-1993). We sought to (a) verify this decline in mortality and (b) better understand its possible relationship to CHQC. We employed regression analysis to compare mortality rate trends for Cleveland versus the rest of Ohio using Ohio Hospital Association inpatient mortality data. We found that the rate of decline in mortality in Cleveland (-.218% per 6 months; 95% confidence limits, -.278% to -.159% per 6 months) was statistically indistinguishable from that in the rest of the state (-.188% per 6 months; 95% confidence limits, -.234% to -.143% per 6 months) (P = .35). We could not demonstrate a significant beneficial effect of the CHQC project on hospital mortality in Cleveland. Inpatient mortality was simultaneously declining at a statistically indistinguishable rate throughout the state.
authors.affiliation: Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, Ohio 44195, USA. Cloughj@ccf.org
authors.forename: John D
authors.initials: JD
authors.lastname: Clough
authors.forename: David
authors.initials: D
authors.lastname: Engler
authors.forename: Richard
authors.initials: R
authors.lastname: Snow
authors.forename: Phillip E
authors.initials: PE
authors.lastname: Canuto
mesh_terms: D006302:Health Services Research; D017052:Hospital Mortality / Q000639:trends*; D006786:Hospitals, Urban / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007255:Information Services; D009820:Ohio / Q000453:epidemiology; D015397:Program Evaluation; D019984:Quality Indicators, Health Care; D020379:Risk Adjustment; D012941:Social Responsibility; D017749:Total Quality Management