Weiyan Jian 1,2 , Jose Figueroa 3,4 , Liana Woskie 5,6 , Xi Yao 7 , Yuqi Zhou 7 , Zhengxiang Li 8 , Changan Li 8 , Li Yao 9 , Winnie C Yip 10 Show Affiliations »
Abstract
OBJECTIVE: To empirically assess the quality of hospital care in China and trends over a 5-year period during which the government significantly increased its investment in healthcare. DESIGN: Retrospective, observational study comparing hospital quality between two periods: October 2012-March 2013 and October 2017-March 2018. SETTING: 1-2 of the most reputable large tertiary hospitals in each of the 25 provinces in Mainland China (total of 33). PARTICIPANTS: Adults 18 years or older admitted with acute myocardial infarction (AMI) (n = 7031), cerebral ischaemic stroke (n = 12 008), chronic obstructive pulmonary disease (COPD) (n = 11 836) and bacterial pneumonia (n = 4263). MAIN OUTCOME MEASURES: Process-based quality measures, including seven AMI measures, three stroke measures, four COPD measures and six pneumonia measures. RESULTS: In 2012/2013, Chinese hospitals had variable performance on AMI measures, including prescribing aspirin on arrival (80.7%), and discharging patients on aspirin (79.2%), β-blockers (60.8%) or statins (75.8%). This was similar for stroke cases and pneumonia cases. Smoking cessation advice was given at high rates across conditions though rates of influenza/pneumococcal vaccines were performed <1%. In 2017/2018, Chinese hospitals experienced no differences across most quality measures. Performance declined for two measures: aspirin on arrival for AMI cases and blood cultures before antibiotics for pneumonia cases. Performance increased for two measures: percutaneous coronary intervention within 90 min in ST segment elevation myocardial infarction cases (66.6% vs 80.1%, p<0.001) and statins at discharge for stroke cases (64.7% vs 78.7%, p<0.001). Compared with US hospitals, Chinese hospitals underperformed across most measures. CONCLUSIONS: Chinese hospitals had low and variable performances across most quality measures for common medical conditions. Quality of care generally does not appear to be improving post national health reform. The Chinese government should include quality of care improvement in its health reform priorities to ensure patients receive appropriate and effective care. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
OBJECTIVE: To empirically assess the quality of hospital care in China and trends over a 5-year period during which the government significantly increased its investment in healthcare. DESIGN: Retrospective, observational study comparing hospital quality between two periods: October 2012-March 2013 and October 2017-March 2018. SETTING: 1-2 of the most reputable large tertiary hospitals in each of the 25 provinces in Mainland China (total of 33). PARTICIPANTS : Adults 18 years or older admitted with acute myocardial infarction (AMI) (n = 7031), cerebral ischaemic stroke (n = 12 008), chronic obstructive pulmonary disease (COPD ) (n = 11 836) and bacterial pneumonia (n = 4263). MAIN OUTCOME MEASURES: Process-based quality measures, including seven AMI measures, three stroke measures, four COPD measures and six pneumonia measures. RESULTS: In 2012/2013, Chinese hospitals had variable performance on AMI measures, including prescribing aspirin on arrival (80.7%), and discharging patients on aspirin (79.2%), β-blockers (60.8%) or statins (75.8%). This was similar for stroke cases and pneumonia cases. Smoking cessation advice was given at high rates across conditions though rates of influenza/pneumococcal vaccines were performed <1%. In 2017/2018, Chinese hospitals experienced no differences across most quality measures. Performance declined for two measures: aspirin on arrival for AMI cases and blood cultures before antibiotics for pneumonia cases. Performance increased for two measures: percutaneous coronary intervention within 90 min in ST segment elevation myocardial infarction cases (66.6% vs 80.1%, p<0.001) and statins at discharge for stroke cases (64.7% vs 78.7%, p<0.001). Compared with US hospitals, Chinese hospitals underperformed across most measures. CONCLUSIONS: Chinese hospitals had low and variable performances across most quality measures for common medical conditions. Quality of care generally does not appear to be improving post national health reform. The Chinese government should include quality of care improvement in its health reform priorities to ensure patients receive appropriate and effective care. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Species
Keywords:
china; health reform; healthcare quality; hospital care
Mesh： See more »
Year: 2019
PMID： 31110140 DOI： 10.1136/bmjqs-2018-008938
Source DB: PubMed Journal: BMJ Qual Saf ISSN： 2044-5415 Impact factor: 7.035