Evidence map›Paper›PMID 30337294›Full record

Observational studyBMJ (Clinical research ed.)2018

Association between patient outcomes and accreditation in US hospitals: observational study.

Miranda B Lam, Jose F Figueroa, Yevgeniy Feyman, Kimberly E Reimold, E John Orav, Ashish K Jha

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis.International journal of environmental research and public health · 2022
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Hospital Accreditation Type and Patient Safety Outcomes: A National Comparison.Advances in health information science and practice · 2026
    Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. History and Role of Quality Accreditation.Clinics in colon and rectal surgery · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Miranda B LamDepartment of Radiation Oncology, Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA, USA.
Jose F FigueroaDepartment of Medicine, Harvard Medical School, Boston, MA, USA.
Yevgeniy FeymanDepartment of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA 02115, USA.
Kimberly E ReimoldDepartment of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA 02115, USA.
E John OravDepartment of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA.
Ashish K JhaDepartment of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA 02115, USA ajha@hsph.harvard.edu.

Funding

Harvard Clinical and Translational Science CenterKL2TR001100 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$8.5M
NCATS NIH HHS KL2 TR001100
6 · The paper itself

Abstract

objectivesTo determine whether patients admitted to US hospitals that are accredited have better outcomes than those admitted to hospitals reviewed through state surveys, and whether accreditation by The Joint Commission (the largest and most well known accrediting body with an international presence) confers any additional benefits for patients compared with other independent accrediting organizations.

designObservational study.

setting4400 hospitals in the United States, of which 3337 were accredited (2847 by The Joint Commission) and 1063 underwent state based review between 2014 and 2017.

participants4 242 684 patients aged 65 years and older admitted for 15 common medical and six common surgical conditions and survey respondents of the Hospital Consumer Assessment of Healthcare Provider and Systems (HCAHPS).

main outcome measuresRisk adjusted mortality and readmission rates at 30 days and HCAHPS patient experience scores. Hospital admissions were identified from Medicare inpatient files for 2014, and accreditation information was obtained from the Centers for Medicare and Medicaid Services and The Joint Commission.

resultsPatients treated at accredited hospitals had lower 30 day mortality rates (although not statistically significant lower rates, based on the prespecified P value threshold) than those at hospitals that were reviewed by a state survey agency (10.2%

conclusionsUS hospital accreditation by independent organizations is not associated with lower mortality, and is only slightly associated with reduced readmission rates for the 15 common medical conditions selected in this study. There was no evidence in this study to indicate that patients choosing a hospital accredited by The Joint Commission confer any healthcare benefits over choosing a hospital accredited by another independent accrediting organization.

Indexed as

AccreditationOutcome Assessment, Health CarePatient AdmissionQuality Assurance, Health CareAgedFemaleHospitalsHumansJoint Commission on Accreditation of Healthcare OrganizationsMaleSurveys and QuestionnairesUnited States

Identifiers

PMID30337294
PMCPMC6193202

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

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.