We hypothesize that robust measurement of these financial measures and quality and safety measures improve the likelihood of observing the relationship between poor financial health and inferior hospital quality of care and patient safety. ![]() While most previous studies have used limited approaches in describing the abstract measures representing hospital financial health and quality of care, this paper considers an entire profile of financial characteristics and patient quality and safety measures. ![]() ![]() The expansion of public reporting by the Centers for Medicare and Medicaid Services (CMS), as part of VBP, has widened the pool of measures available for quality analysis. Concerning quality performance, studies have generally focused on specific outcomes, such as mortality, or hospital readmission from conditions such as pneumonia, heart failure, or myocardial infarction. Other studies used only narrow measures of hospital financial performance (e.g., operating margin), which do not capture the full range of revenue potentially available for investment in quality improvements. When considering financial performance, many financial distress models relied on specific indicators of stress, including bankruptcy and closure data, which are easier to obtain but do not represent the range of financial health. Lack of clear associations may be due to the poor predictive validity of the measures of finances and of quality. Studies directly examining the correlation between financial status and quality and safety of patient care, however, have been equivocal and the findings uncertain. Prior literature suggests that some aspects of patient care may be compromised as a hospital’s financial condition declines. Otherwise, these programs run the risk of perpetuating the “rich get richer” history of the American health care system and will continue to penalize safety net hospitals and their underserved populations Initiatives to financially incentivize quality, such as public reporting and value-based payment (VBP), will succeed in improving population health for all only if they are designed to account for the complicated relationship between quality and facility financial stability. Hospitals face considerable pressure to lower costs while maintaining quality outcomes. Efforts to control the high costs of health care in the United States presuppose hospitals can do more with less. Is the financial status of a hospital related to the quality and safety of care delivered? While this simple and straightforward question has attracted considerable attention, it has been remarkably difficult to answer. The authors did not have special access privileges.įunding: The authors received no specific funding for this work.Ĭompeting interests: The authors have declared that no competing interests exist. NYSDOH data were used due to ease of access. The CMS cost report data was obtained from the NYSDOH, although comparable data is publicly available from CMS. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: The data underlying the results presented in the study are available from New York State health data NY data website, represented by the following documents: “All Payer Inpatient Quality Indicators (IQI) by Hospital (SPARCS): Beginning 2009” as well as “All Payer Patient Safety Indicators (PSI) by Hospital: Beginning 2009”. Received: SeptemAccepted: JPublished: August 16, 2019Ĭopyright: © 2019 Akinleye et al. PLoS ONE 14(8):Įditor: Takeru Abe, Yokohama City University, JAPAN The correlation between the composite financial performance score and the composite quality/safety performance score was calculated using linear regression adjusting for hospital characteristics.Ĭitation: Akinleye DD, McNutt L-A, Lazariu V, McLaughlin CC (2019) Correlation between hospital finances and quality and safety of patient care. ![]() Hospital quality and patient safety were measured with a composite quality/safety performance score derived from principal component analysis, utilizing a range of established quality and safety indicators including: risk-standardized inpatient mortality, 30-day mortality, 30-day readmissions for select conditions, patient safety indicators from inpatient admissions, process of care chart reviews, CMS value-based purchasing total performance score and patient experience of care surveys. The hospital financial data from the Centers for Medicare and Medicaid Services (CMS) cost report were used to develop a composite financial performance score using principal component analysis. This 2014 cross-sectional study investigated hospital financial condition and hospital quality and safety at acute care hospitals.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |