Quality of Care Provided to Individual Patients in US Hospitals

Patient-level data from the Centers for Medicare and Medicaid Services (CMS) reveal that more than 40 percent of heart failure (HF) patients at U.S. hospitals do not receive all indicated treatment procedures.

In 2005, as part of the Hospital Quality Alliance (HQA) program, CMS collected data from virtually all non-federal U.S. hospitals. This study used CMS data to determine how often hospitals completed all recommended treatments for three conditions: HF, acute myocardial infarction (AMI), and community acquired pneumonia (PN). Patient-level data enabled researchers to relate hospital characteristics to the quality of care for individual patients with each condition. The authors also examined how eligibility for specific treatment procedures and the number of treatments for which a patient was eligible affected hospital performance for each condition.

Key Findings:

  • Failure to provide complete discharge instructions changed the percentage of patients receiving all HF treatments from 83.8 percent to 57.3 percent.
  • The percentage of patients receiving all recommended treatments declined as the number of recommended treatments increased.

An advantage that this study has relative to previous studies of hospital care is its use of the Institute of Medicine’s all-or-none performance measure. Previous studies used measurements of care that created averages of hospital-level performance.