Observational studyBMJ open2020
Appropriateness, effectiveness and safety of care delivered in Canadian hospitals: a longitudinal assessment on the utility of publicly reported performance trend data between 2012-2013 and 2016-2017.
Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed.
- Hospital performance evaluation indicators: a scoping review.BMC health services research · 2024Article
- Trust performance in managing inflammatory arthritis over time in England and Wales: a latent class analysis approach.Rheumatology advances in practice · 2024Article
- Observational
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the utility of publicly reported performance trend results of Canadian hospitals (by hospital size/type and jurisdiction).
designLongitudinal observational study.
setting489 hospitals in Canada between fiscal years 2012-2013 and 2016-2017.
participantsAnalysis focused on indicator results of individual Canadian hospitals. PRIMARY AND SECONDARY OUTCOMES: Eight outcome indicators of hospital performance: in-hospital mortality (2), readmissions (4) and adverse events (2). Performance trend outcomes of improving, weakening or no change over time. Comparators in performance by hospital size/type of above, below or same as average.
resultsAt the national level, between 2012-2013 and 2016-2017, Canadian hospitals largely reduced in-hospital mortality: hospital deaths (hospital standardised mortality ratio) -9%; hospital deaths following major surgery -11.1%. Conversely, readmission to hospital increased nationwide: medical 1.5%; obstetric 5%; patients aged 19 years and younger 4.6% and surgical 3%. In-hospital sepsis declined -7.1%. Approximately 10% of the 489 hospitals in this study had a trend of improving performance over time (n=49) in one or more indicators, and a similar number showed a weakening performance over time (n=52). Roughly half of the hospitals in this study (n=224) had no change in performance over time for at least four out of the eight indicators. No single hospital had an improving or weakening trend in more than two indicators. Teaching and larger-sized hospitals showed a higher ratio of improving performance compared with smaller-sized hospitals.
conclusionsAnalysis of Canadian hospital performance through eight indicators shows improvement of in-hospital mortality and in-hospital sepsis, but rising rates of readmissions. Subdividing the analysis by hospital size/type shows greater instances of improvement in teaching and larger-sized hospitals. There is no clear pattern of a particular province/territory with a significant number of hospitals with improving or weakening trends. The overall assessment of trends of improving and weakening as presented in this study can be used more systematically in monitoring progress.
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