Søren Bie Bogh1, Anne Mette Falstie-Jensen2, Paul Bartels3, Erik Hollnagel1, Søren Paaske Johnsen2. 1. Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, Odense C DK-5000, Denmark Centre for Quality, Region of Southern Denmark, P.V. Tuxenvej 5, Middelfart DK-5500, Denmark. 2. Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N DK-8200, Denmark. 3. The Danish Clinical Registries, Olof Palmes Allé 15, Aarhus N DK-8200, Denmark.
Abstract
OBJECTIVE: To examine whether performance measures improve more in accredited hospitals than in non-accredited hospital. DESIGN AND SETTING: A historical follow-up study was performed using process of care data from all public Danish hospitals in order to examine the development over time in performance measures according to participation in accreditation programs. PARTICIPANTS: All patients admitted for acute stroke, heart failure or ulcer at Danish hospitals. INTERVENTION: Hospital accreditation by either The Joint Commission International or The Health Quality Service. MEASUREMENTS: The primary outcome was a change in opportunity-based composite score and the secondary outcome was a change in all-or-none scores, both measures were based on the individual processes of care. These processes included seven processes related to stroke, six processes to heart failure, four to bleeding ulcer and four to perforated ulcer. RESULTS: A total of 27 273 patients were included. The overall opportunity-based composite score improved for both non-accredited and accredited hospitals (13.7% [95% CI 10.6; 16.8] and 9.9% [95% 5.4; 14.4], respectively), but the improvements were significantly higher for non-accredited hospitals (absolute difference: 3.8% [95% 0.8; 8.3]). No significant differences were found at disease level. The overall all-or-none score increased significantly for non-accredited hospitals, but not for accredited hospitals. The absolute difference between improvements in the all-or-none score at non-accredited and accredited hospitals was not significant (3.2% [95% -3.6:9.9]). CONCLUSIONS: Participating in accreditation was not associated with larger improvement in performance measures for acute stroke, heart failure or ulcer.
OBJECTIVE: To examine whether performance measures improve more in accredited hospitals than in non-accredited hospital. DESIGN AND SETTING: A historical follow-up study was performed using process of care data from all public Danish hospitals in order to examine the development over time in performance measures according to participation in accreditation programs. PARTICIPANTS: All patients admitted for acute stroke, heart failure or ulcer at Danish hospitals. INTERVENTION: Hospital accreditation by either The Joint Commission International or The Health Quality Service. MEASUREMENTS: The primary outcome was a change in opportunity-based composite score and the secondary outcome was a change in all-or-none scores, both measures were based on the individual processes of care. These processes included seven processes related to stroke, six processes to heart failure, four to bleeding ulcer and four to perforated ulcer. RESULTS: A total of 27 273 patients were included. The overall opportunity-based composite score improved for both non-accredited and accredited hospitals (13.7% [95% CI 10.6; 16.8] and 9.9% [95% 5.4; 14.4], respectively), but the improvements were significantly higher for non-accredited hospitals (absolute difference: 3.8% [95% 0.8; 8.3]). No significant differences were found at disease level. The overall all-or-none score increased significantly for non-accredited hospitals, but not for accredited hospitals. The absolute difference between improvements in the all-or-none score at non-accredited and accredited hospitals was not significant (3.2% [95% -3.6:9.9]). CONCLUSIONS: Participating in accreditation was not associated with larger improvement in performance measures for acute stroke, heart failure or ulcer.
Authors: Viktor Dombrádi; Barnabás Margitai; Csaba Dózsa; Orsolya Karola Bárdos-Csenteri; János Sándor; Tibor Gáll; Sándor Gődény Journal: BMJ Open Date: 2018-02-01 Impact factor: 2.692
Authors: Louise A Ellis; Anne Nicolaisen; Søren Bie Bogh; Kate Churruca; Jeffrey Braithwaite; Christian von Plessen Journal: BMC Health Serv Res Date: 2020-04-15 Impact factor: 2.655