ArticleBMC health services research2017
Hospital quality measures: are process indicators associated with hospital standardized mortality ratios in French acute care hospitals?
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Analysis of structure indicators influencing 3-h and 6-h compliance with the surviving sepsis campaign guidelines in China: a systematic review.European journal of medical research · 2021Pooled it
- Estimating the causal effect of a quality assurance program on quality of care in Germany.BMC health services research · 2025Article
- Article
- Predicting End-of-Life in a Hospital Setting.Journal of multidisciplinary healthcare · 2024Article
- Perioperative Adverse Outcome and Its Predictors After Emergency Laparotomy Among Sigmoid Volvulus Patients: Retrospective Follow-Up Study.Open access emergency medicine : OAEM · 2023Article
- The Measurement Error Elephant in the Room: Challenges and Solutions to Measurement Error in Epidemiology.Epidemiologic reviews · 2022Review
- Implementation of anesthesia quality indicators in Germany : A prospective, national, multicenter quality improvement study.Der Anaesthesist · 2021Article
- Nurse staffing practices and adverse events in acute care hospitals: The research protocol of a multisite patient-level longitudinal study.Journal of advanced nursing · 2021Article
- Emergency Department Quality Dashboard; a Systematic Review of Performance Indicators, Functionalities, and Challenges.Archives of academic emergency medicine · 2021Article
- Factors Associated with In-Hospital Mortality in Acute Care Hospital Settings: A Prospective Observational Study.International journal of environmental research and public health · 2020Observational
- [Implementation of anesthesia quality indicators in Germany : A prospective, national, multicenter quality improvement study].Der Anaesthesist · 2020Article
- What is the relationship between mortality alerts and other indicators of quality of care? A national cross-sectional study.Journal of health services research & policy · 2020Article
- A machine learning model for predicting severity-adjusted in-hospital mortality in pneumonia patients.Digital healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundResults of associations between process and mortality indicators, both used for the external assessment of hospital care quality or public reporting, differ strongly across studies. However, most of those studies were conducted in North America or United Kingdom. Providing new evidence based on French data could fuel the international debate on quality of care indicators and help inform French policy-makers. The objective of our study was to explore whether optimal care delivery in French hospitals as assessed by their Hospital Process Indicators (HPIs) is associated with low Hospital Standardized Mortality Ratios (HSMRs).
methodsThe French National Authority for Health (HAS) routinely collects for each hospital located in France, a set of mandatory HPIs. Five HPIs were selected among the process indicators collected by the HAS in 2009. They were measured using random samples of 60 to 80 medical records from inpatients admitted between January 1st, 2009 and December 31, 2009 in respect with some selection criteria. HSMRs were estimated at 30, 60 and 90 days post-admission (dpa) using administrative health data extracted from the national health insurance information system (SNIIR-AM) which covers 77% of the French population. Associations between HPIs and HSMRs were assessed by Poisson regression models corrected for measurement errors with a simulation-extrapolation (SIMEX) method.
resultsMost associations studied were not statistically significant. Only two process indicators were found associated with HSMRs. Completeness and quality of anesthetic records was negatively associated with 30 dpa HSMR (0.72 [0.52-0.99]). Early detection of nutritional disorders was negatively associated with all HSMRs: 30 dpa HSMR (0.71 [0.54-0.95]), 60 dpa HSMR (0.51 [0.39-0.67]) and 90 dpa HSMR (0.52 [0.40-0.68]).
conclusionIn absence of gold standard of quality of care measurement, the limited number of associations suggested to drive in-depth improvements in order to better determine associations between process and mortality indicators. A smart utilization of both process and outcomes indicators is mandatory to capture aspects of the hospital quality of care complexity.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.