Impact of Date Stamping on Patient Safety Measurement in CABG Patients
Author Information
Author(s): Glance Laurent G, Li Yue, Osler Turner M, Mukamel Dana B, Dick Andrew W
Primary Institution: University of Rochester School of Medicine and Dentistry
Hypothesis
Can the AHRQ Patient Safety Indicators accurately measure hospital complication rates when using present-on-admission codes?
Conclusion
Using the present-on-admission indicator increases the accuracy of AHRQ Patient Safety Indicators in measuring adverse outcomes.
Supporting Evidence
- The false positive error rate was greater than or equal to 20% for four of the eight PSIs examined.
- Pairwise comparison of hospital risk-adjusted PSI rates showed almost perfect agreement for five of the eight PSIs.
- Adding the POA indicator generally decreases a hospital's PSI rates because it distinguishes pre-existing conditions from complications.
Takeaway
This study shows that knowing if a patient's condition was there before they were admitted can help hospitals better understand how well they are doing at preventing complications.
Methodology
Retrospective cohort study using the 1998–2000 California State Inpatient Database to analyze patients undergoing isolated CABG surgery.
Potential Biases
Potential bias due to variability in coding practices across hospitals.
Limitations
The study assumes the POA indicator accurately distinguishes complications from pre-existing conditions.
Participant Demographics
Patients undergoing isolated CABG surgery in California.
Statistical Information
P-Value
≤ 0.05
Confidence Interval
(0.67, 0.91)
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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