Analysis of federal process of care data reported from hospitals in rural westernmost North Carolina.
OBJECTIVE
To evaluate standardized process of care data collected on selected hospitals serving a remote, rural section of westernmost North Carolina.


METHODS
Centers for Medicare & Medicaid Services (CMS) data were retrospectively analyzed for 21 clinical parameters at Fannin Regional Hospital (FRH), Murphy Medical Center (MMC), and Union General Hospital (UGH). A binomial test was used to compare each study site to state (NC) and national (U.S.A.) average.


RESULTS
Summary data showed FRH to have higher scores on a significant number of standardized clinical process of care measures compared to state (p < 0.05) and national (p < 0.005) averages. Too few process of care measures at UGH were significantly higher than state and national averages to conclude that differences were not due to Type I error. Similarly, at MMC too few process of care measures were significantly higher than national averages to conclude that observed differences were not attributable to Type I error. MMC did not achieve a significantly higher score on any process of care measure when compared to state averages.


CONCLUSIONS
Despite limitations associated with summary data analysis, the CMS "Hospitals Compare" information suggests that process of care scores at FRH are significantly higher than the state and national average. As these hospital quality data are freely available to patients, it remains to be determined what impact this may have on hospital volume and/or market share in this region. Additional research is planned to identify process of care trends in this geographical area.
Department of Obstetrics & Gynaecology, School of Medicine, Royal College of Surgeons of Ireland/The Sims Institute, Dublin, Ireland. drscottsills@sims.ie
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Sills
B A
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Lotto
W S
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Bremer
A J
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Bacchi
A P H
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Walsh
D006780:Hospitals, Rural / Q000592:standards*; D006801:Humans; D009657:North Carolina; D017064:Process Assessment, Health Care; D012189:Retrospective Studies