Hospital quality reporting and improvement in quality of care for patients with acute myocardial infarction

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Abstract

Background

Although public reporting of hospital performance is becoming common, it remains uncertain whether public reporting leads to improvement in clinical outcomes. This study was conducted to evaluate whether enrollment in a quality reporting project is associated with improvement in quality of care for patients with acute myocardial infarction.

Methods

We conducted a quasi-experimental study using hospital census survey and national inpatient database in Japan. Hospitals enrolled in a ministry-led quality reporting project were matched with non-reporting control hospitals by one-to-one propensity score matching using hospital characteristics. Using the inpatient data of acute myocardial infarction patients hospitalized in the matched hospitals during 2011–2013, difference-in-differences analyses were conducted to evaluate the changes in unadjusted and risk-adjusted in-hospital mortality rates over time that are attributable to intervention.

Results

Matching between hospitals created a cohort of 30,220 patients with characteristics similar between the 135 reporting and 135 non-reporting hospitals. Overall in-hospital mortality rates were 13.2% in both the reporting and non-reporting hospitals. There was no significant association between hospital enrollment in the quality reporting project and change over time in unadjusted mortality (OR, 0.98; 95% CI, 0.80–1.22). In 28,168 patients eligible for evaluation of risk-adjusted mortality, enrollment was also not associated with change in risk-adjusted mortality (OR, 0.98; 95% CI, 0.81–1.17).

Conclusions

Enrollment in the quality reporting project was not associated with short-term improvement in quality of care for patients with acute myocardial infarction. Additional efforts may be necessary to improve quality of care.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3330-4) contains supplementary material, which is available to authorized users.

Related collections

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Author and article information

Contributors

Hayato Yamana:

ORCID: http://orcid.org/0000-0003-2214-6695

+81-3-5841-1887 , yamana-tky@umin.ac.jp

Mariko Kodan: kodan-mariko@hosp.go.jp

Sachiko Ono: sachikoono-tky@umin.ac.jp

Kojiro Morita: kojiromorita-tky@umin.ac.jp

Hiroki Matsui: ptmatsui-tky@umin.ac.jp

Kiyohide Fushimi: kfushimi.hci@tmd.ac.jp

Tomoaki Imamura: imamurat@naramed-u.ac.jp

Hideo Yasunaga: yasunagah-tky@umin.ac.jp

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 4 July 2018

Publication date PMC-release: 4 July 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 523

Affiliations

[1 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Department of Health Services Research, Graduate School of Medicine, , The University of Tokyo, ; 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan

[2 ]GRID grid.416698.4, Department of Clinical Data Management and Research, Clinical Research Center, , National Hospital Organization Headquarters, ; 2-5-21 Higashigaoka, Meguro-ku, Tokyo, 152-8621 Japan

[3 ]ISNI 0000 0001 1014 9130, GRID grid.265073.5, Department of Health Policy and Informatics, , Tokyo Medical and Dental University Graduate School of Medicine, ; 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan

[4 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Department of Biostatistics & Bioinformatics, , The University of Tokyo, ; 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan

[5 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Department of Clinical Epidemiology and Health Economics, School of Public Health, , The University of Tokyo, ; 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan

[6 ]ISNI 0000 0004 0372 782X, GRID grid.410814.8, Department of Public Health, Health Management and Policy, , Nara Medical University, ; 840 Shijo-cho, Kashihara, Nara, 634-0813 Japan

Author information

Hayato Yamana http://orcid.org/0000-0003-2214-6695

Article

Publisher ID: 3330

DOI: 10.1186/s12913-018-3330-4

PMC ID: 6033287

PubMed ID: 29973281

SO-VID: 036ef002-1a72-4cde-bb1a-2c35ef6cf31a

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 30 November 2017

Date accepted : 26 June 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100003478, Ministry of Health, Labour and Welfare;

Funded by: FundRef http://dx.doi.org/10.13039/501100001700, Ministry of Education, Culture, Sports, Science and Technology;

Funded by: FundRef http://dx.doi.org/10.13039/100009619, Japan Agency for Medical Research and Development;

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: quality improvement,mortality,cardiovascular diseases

Data availability: