Hospital variations in adverse patient outcomes

Careful review of the literature suggests that the conceptual problem in analyzing hospitals' quality of care is the difficulty of identifying problem domains of hospital care. An appropriate measurement model using multiple indicators of hospital quality problems is developed and evaluated. Adverse patient outcomes reflecting the quality problems are compiled from a peer review organization's generic screen indicators for 85 acute care hospitals. Predictor variables of adverse outcomes include bed size, number of high-technology services offered, case mix, severity of patients treated, ownership, case mix, severity of patients treated, ownership, net profit, market share, efficiency, teaching status, and metropolitan size. The findings show that hospital characteristics exert limited effects on adverse outcomes. Efficiency and average length of stay are the only statistically significant factors that explain the variation in adverse outcomes.