title: Processes of care and outcomes for community-acquired pneumonia.
abstract: BACKGROUND
  Although processes of care are common proxies for health care quality, their associations with medical outcomes remain uncertain.
  
  
  METHODS
  For 2076 patients hospitalized with pneumonia from 32 emergency departments, we used multilevel logistic regression modeling to assess independent associations between patient outcomes and the performance of 4 individual processes of care (assessment of oxygenation, blood cultures, and rapid initiation [<4 hours] and appropriate selection of antibiotic therapy) and the cumulative number of processes of care performed.
  
  
  RESULTS
  Overall, 141 patients (6.8%) died. Mortality was 0.3% to 1.7% lower for patients who had each of the individual processes of care performed (P≥.13 for each comparison); mortality was 7.5% for patients who had 0 to 2 processes of care, 7.2% for those with 3 processes of care, and 5.8% for those with all 4 processes of care performed (P=.39). Mortality was not significantly associated with either individual or cumulative process measures in multivariable models.
  
  
  CONCLUSIONS
  Neither the individual processes of care nor the cumulative number performed is associated with short-term mortality for pneumonia.
authors: Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, USA.
authors: Jonathan S
authors: JS
authors: Lee
authors: Brian A
authors: BA
authors: Primack
authors: Maria K
authors: MK
authors: Mor
authors: Roslyn A
authors: RA
authors: Stone
authors: D Scott
authors: DS
authors: Obrosky
authors: Donald M
authors: DM
authors: Yealy
authors: Michael J
authors: MJ
authors: Fine
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D017714:Community-Acquired Infections / Q000401:mortality* / Q000628:therapy*; D003237:Connecticut / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010414:Pennsylvania / Q000453:epidemiology; D011014:Pneumonia / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: D000890:Anti-Infective Agents