appraising hospital performance by using the jchaocms quality measures in southern italy评价医院性能通过使用jchaocms质量措施在意大利南部.pdfVIP

Appraising Hospital Performance by Using the JCHAO/ CMS Quality Measures in Southern Italy Domenico Flotta, Paolo Rizza, Pierluigi Coscarelli, Claudia Pileggi, Carmelo G. A. Nobile, Maria Pavia* Department of Health Sciences, University of Catanzaro ‘Magna Græcia’, Catanzaro, Italy Abstract Objectives: The main objective of the present study was to estimate the uptake to quality indicators that reflect the current evidence-based recommendations and guidelines. Methods: A retrospective review of medical records of patients admitted to two hospitals in the South of Italy was conducted. For the purposes of the analysis, a sets of quality indicators has been used from the Joint Commission on Accreditation of Hospital Organizations and Centers for Medicare Medicaid Services. Four areas of care were selected: acute myocardial infarction (AMI), heart failure (HF), pneumonia (PN), and surgical care improvement project (SCIP). Frequency or median was calculated, as appropriate, for each indicator. A composite score was calculated to estimate the overall performance for each area of care. Results: A total of 1772 medical records were reviewed. The adherence rates showed a wide-ranging variability among the selected indicators. The use of aspirin and angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for AMI, the use of ACEI or ARB for HF, the use of appropriate thromboembolism prophylaxis and appropriate hair removal for surgical patients almost approached optimal adherence. At the other extreme, rates regarding adherence to smoking-cessation counseling in AMI and HF patients, discharge instructions in HF patients, and influenza and pneumococcal vaccination in pneumonia patients were noticeably intangible. Overall, the recommend