Hospital Cost of Care, Quality of Care, and Readmission Rates Penny Wise and Pound Foolish?
Hospital Cost of Care, Quality of Care, and Readmission Rates Penny Wise and Pound Foolish?
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DOI：
10.1001/archinternmed.2009.511
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发表时间：
2010-02-22
影响因子：
--
通讯作者：
Epstein, Arnold M.
中科院分区：
文献类型：
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作者：
Chen, Lena M.;Jha, Ashish K.;Epstein, Arnold M.
背景：医院面临着越来越大的压力，以降低护理成本，同时提高护理质量。目前还不清楚，如果努力降低医院的护理成本将产生不利影响的护理质量或增加下游住院costsofcare.Methods：我们进行了一项观察性横断面研究，美国医院出院的医疗保险患者充血性心力衰竭（CHF）或肺炎在2006年。对于每种情况，我们检查了医院护理成本与以下变量之间的关联：护理过程质量、30天死亡率、再入院率和6个月住院护理成本。与CHF治疗成本最低的四分之一医院相比，费用最高四分位数的医院有较高的护理质量评分（89.9%对85.5%）和较低的CHF死亡率（9.8%对10.8%）（P
Background: Hospitals face increasing pressure to lower cost of care while improving quality of care. It is unclear if efforts to reduce hospital cost of care will adversely affect quality of care or increase downstream inpatient cost of care.Methods: We conducted an observational cross-sectional study of US hospitals discharging Medicare patients for congestive heart failure (CHF) or pneumonia in 2006. For each condition, we examined the association between hospital cost of care and the following variables: process quality of care, 30-day mortality rates, readmission rates, and 6-month inpatient cost of care.Results: Compared with hospitals in the lowest-cost quartile for CHF care, hospitals in the highest-cost quartile had higher quality-of-care scores (89.9% vs 85.5%) and lower mortality for CHF(9.8% vs 10.8%) (P