TY - JOUR PY - 2010// TI - Centers for Medicare and Medicaid services quality indicators do not correlate with risk-adjusted mortality at trauma centers JO - Journal of trauma A1 - Shafi, Shahid A1 - Parks, Jennifer A1 - Ahn, Chul A1 - Gentilello, Larry M. A1 - Nathens, Avery B. A1 - Hemmila, Mark R. A1 - Pasquale, Michael D. A1 - Meredith, J. W. A1 - Cryer, Henry G. A1 - Goble, Sandra A1 - Neil, Melanie A1 - Price, Chrystal A1 - Fildes, John J. SP - 771 EP - 777 VL - 68 IS - 4 N2 - OBJECTIVES: The Centers for Medicare and Medicaid Services (CMS) publicly reports hospital compliance with evidence-based processes of care as quality indicators. We hypothesized that compliance with CMS quality indicators would correlate with risk-adjusted mortality rates in trauma patients. METHODS: A previously validated risk-adjustment algorithm was used to measure observed-to-expected mortality ratios (O/E with 95% confidence interval) for Level I and II trauma centers using the National Trauma Data Bank data. Adult patients (>or=16 years) with at least one severe injury (Abbreviated Injury Score >or=3) were included (127,819 patients). Compliance with CMS quality indicators in four domains was obtained from Hospital Compare website: acute myocardial infarction (8 processes), congestive heart failure (4 processes), pneumonia (7 processes), surgical infections (3 processes). For each domain, a single composite score was calculated for each hospital. The relationship between O/E ratios and CMS quality indicators was explored using nonparametric tests. RESULTS: There was no relationship between compliance with CMS quality indicators and risk-adjusted outcomes of trauma patients. CONCLUSIONS: CMS quality indicators do not correlate with risk-adjusted mortality rates in trauma patients. Hence, there is a need to develop new trauma-specific process of care quality indicators to evaluate and improve quality of care in trauma centers.

Language: en

LA - en SN - 0022-5282 UR - http://dx.doi.org/10.1097/TA.0b013e3181d03a20 ID - ref1 ER -