Abstract
OBJECTIVES:: The Centers for Medicare and Medicaid Services (CMS) publicly reports hospital compliance with evidence-based processes of care as quality indicators. We hypothesized that compliance with CMS quality indicators would correlate with risk-adjusted mortality rates in trauma patients. METHODS:: A previously validated risk-adjustment algorithm was used to measure observed-to-expected mortality ratios (O/E with 95% confidence interval) for Level I and II trauma centers using the National Trauma Data Bank data. Adult patients (≥ years) with at least one severe injury (Abbreviated Injury Score ≥ 3) were included (127,819 patients). Compliance with CMS quality indicators in four domains was obtained from Hospital Compare website: acute myocardial infarction (8 processes), congestive heart failure (4 processes), pneumonia (7 processes), surgical infections (3 processes). For each domain, a single composite score was calculated for each hospital. The relationship between O/E ratios and CMS quality indicators was explored using nonparametric tests. RESULTS:: There was no relationship between compliance with CMS quality indicators and risk-adjusted outcomes of trauma patients. CONCLUSIONS:: CMS quality indicators do not correlate with risk-adjusted mortality rates in trauma patients. Hence, there is a need to develop new trauma-specific process of care quality indicators to evaluate and improve quality of care in trauma centers.
Original language | English (US) |
---|---|
Pages (from-to) | 771-776 |
Number of pages | 6 |
Journal | Journal of Trauma - Injury, Infection and Critical Care |
Volume | 68 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2010 |
Keywords
- Quality of care
- TQIP-Trauma Quality Improvement Program: Hospital Compare
- Trauma systems
ASJC Scopus subject areas
- Surgery
- Critical Care and Intensive Care Medicine