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Hospital quality measures: are process indicators associated with hospital standardized mortality ratios in French acute care hospitals?

Overview of attention for article published in BMC Health Services Research, August 2017
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Title
Hospital quality measures: are process indicators associated with hospital standardized mortality ratios in French acute care hospitals?
Published in
BMC Health Services Research, August 2017
DOI 10.1186/s12913-017-2534-3
Pubmed ID
Authors

Marcus Ngantcha, Marie-Annick Le-Pogam, Sophie Calmus, Catherine Grenier, Isabelle Evrard, Agathe Lamarche-Vadel, Grégoire Rey

Abstract

Results of associations between process and mortality indicators, both used for the external assessment of hospital care quality or public reporting, differ strongly across studies. However, most of those studies were conducted in North America or United Kingdom. Providing new evidence based on French data could fuel the international debate on quality of care indicators and help inform French policy-makers. The objective of our study was to explore whether optimal care delivery in French hospitals as assessed by their Hospital Process Indicators (HPIs) is associated with low Hospital Standardized Mortality Ratios (HSMRs). The French National Authority for Health (HAS) routinely collects for each hospital located in France, a set of mandatory HPIs. Five HPIs were selected among the process indicators collected by the HAS in 2009. They were measured using random samples of 60 to 80 medical records from inpatients admitted between January 1st, 2009 and December 31, 2009 in respect with some selection criteria. HSMRs were estimated at 30, 60 and 90 days post-admission (dpa) using administrative health data extracted from the national health insurance information system (SNIIR-AM) which covers 77% of the French population. Associations between HPIs and HSMRs were assessed by Poisson regression models corrected for measurement errors with a simulation-extrapolation (SIMEX) method. Most associations studied were not statistically significant. Only two process indicators were found associated with HSMRs. Completeness and quality of anesthetic records was negatively associated with 30 dpa HSMR (0.72 [0.52-0.99]). Early detection of nutritional disorders was negatively associated with all HSMRs: 30 dpa HSMR (0.71 [0.54-0.95]), 60 dpa HSMR (0.51 [0.39-0.67]) and 90 dpa HSMR (0.52 [0.40-0.68]). In absence of gold standard of quality of care measurement, the limited number of associations suggested to drive in-depth improvements in order to better determine associations between process and mortality indicators. A smart utilization of both process and outcomes indicators is mandatory to capture aspects of the hospital quality of care complexity.

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The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 57 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 57 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 8 14%
Researcher 6 11%
Student > Ph. D. Student 6 11%
Student > Postgraduate 5 9%
Student > Bachelor 3 5%
Other 11 19%
Unknown 18 32%
Readers by discipline Count As %
Nursing and Health Professions 11 19%
Medicine and Dentistry 7 12%
Pharmacology, Toxicology and Pharmaceutical Science 3 5%
Business, Management and Accounting 3 5%
Neuroscience 3 5%
Other 10 18%
Unknown 20 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 August 2017.
All research outputs
#14,299,546
of 22,999,744 outputs
Outputs from BMC Health Services Research
#5,095
of 7,702 outputs
Outputs of similar age
#175,086
of 317,366 outputs
Outputs of similar age from BMC Health Services Research
#109
of 157 outputs
Altmetric has tracked 22,999,744 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,702 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.8. This one is in the 33rd percentile – i.e., 33% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 317,366 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 157 others from the same source and published within six weeks on either side of this one. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.