Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and...

Area of Science:

• Healthcare Quality
• Patient Safety
• Cardiology

Background:

• Hospitals with high heart failure (HF) mortality and readmission rates may indicate broader quality concerns.
• This study investigates the link between hospital performance in HF mortality/readmission and patient safety adverse events.

Purpose of the Study:

• To evaluate the association between hospital performance on mortality and readmission rates and the occurrence of safety adverse events in heart failure patients.

Main Methods:

• A cross-sectional study linked Medicare patient safety data (2009-2019) with hospital HF mortality/readmission data (2005-2016).
• Hospitals were categorized as 'better,' 'worse,' or 'average' based on risk-standardized mortality and readmission rates.
• A mixed-effect model assessed the risk of adverse events based on hospital performance categories, adjusted for patient and hospital factors.

Main Results:

• The study included 39,597 HF patients across 3,108 hospitals.
• 12.5% of hospitalizations involved one or more adverse events.
• Patients in 'worse' performing hospitals (high mortality/readmission) had a significantly higher risk of hospital-acquired adverse events (aRR 1.24).

Conclusions:

• Hospitals with high 30-day mortality and readmission rates for HF patients face a greater risk of in-hospital adverse events.
• These findings suggest overlapping quality issues may contribute to poor performance in both patient outcomes and safety for HF care.