title: The relationship between hospital market competition, evidence-based performance measures, and mortality for chronic heart failure.
abstract: Using data from the Joint Commission's ORYX initiative and the Medicare Provider Analysis and Review file from 2003 to 2006, this study employed a fixed-effects approach to examine the relationship between hospital market competition, evidence-based performance measures, and short-term mortality at seven days, 30 days, 90 days, and one year for patients with chronic heart failure. We found that, on average, higher adherence with most of the Joint Commission's heart failure performance measures was not associated with lower mortality; the level of market competition also was not associated with any differences in mortality. However, higher adherence with the discharge instructions and left ventricular function assessment indicators at the 80th and 90th percentiles of the mortality distribution was associated with incrementally lower mortality rates. These findings suggest that targeting evidence-based processes of care might have a stronger impact in improving patient outcomes.
authors.affiliation: Analytic Consulting & Research Services, Thomson Reuters Healthcare, Washington, DC 20008, USA. jared.maeda@thomsonreuters.com
authors.forename: Jared Lane K
authors.initials: JL
authors.lastname: Maeda
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Lo Sasso
mesh_terms: D019985:Benchmarking / Q000706:statistics & numerical data*; D002908:Chronic Disease; D004465:Economic Competition / Q000706:statistics & numerical data*; D004469:Economics, Hospital; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006333:Heart Failure / Q000401:mortality*; D006739:Hospital Administration / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D006278:Medicare / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States