Author ORCID Identifier
Alice Brewer: https://orcid.org/0009-0000-9662-5328
M. Courtney Hughes: https://orcid.org/0000-0002-8699-5701
Document Type
Article
Publication Title
Journal of Patient Safety
Abstract
Objectives
The incidence of hospital-acquired conditions (HACs) is a serious public health issue with implications ranging from patient morbidity and mortality to negative financial impacts on patients and health care systems. Despite substantial efforts to address and reduce HACs, research into the effect of quality improvement programs is inconclusive. This study seeks to better understand the relationship between repeated reimbursement penalties and improvement in HAC quality scores.
Methods
A quantitative comparative analysis of U.S. health care data was conducted. Data on quality outcomes and hospital characteristics were sourced from the Hospital-Acquired Condition Reduction Program from fiscal years 2018 and 2019 and the Centers for Medicare & Medicaid Services Inpatient Prospective Payment System impact files, respectively.
Results
In total, 3123 U.S. hospitals were analyzed to compare differences between total HAC scores of hospitals with and without penalties in consecutive years. Hospitals with repeated penalties had significantly greater improvement in scores ( t 497.262 = −13.00, P < 0.001), and the impact was greatest in small hospitals (<100 beds). Repeated penalties had a smaller impact on disproportionate share hospitals (Cohen d = 0.73). Among all hospitals, the effect of repeated penalties was large (Cohen d = 0.75)
Conclusions
This study suggests that repeated penalties can improve quality scores in U.S. hospitals. However, the effect may be exaggerated for smaller hospitals and those that serve patient populations with a relatively higher socioeconomic status. The reason disproportionate share hospitals did not show as much improvement as nondisproportionate hospitals may be because hospitals serving vulnerable populations often have fewer resources.
First Page
198
Last Page
201
DOI
https://doi.org/10.1097/PTS.0000000000001199
Publication Date
2024
Recommended Citation
Brewer A, Hughes MC, Patel K. Impact of repeated reimbursement penalties on hospital total quality scores. Journal of Patient Safety. 2024. Vol. 20(3):198-201. https://doi.org/10.1097/PTS.0000000000001199
Original Citation
Brewer A, Hughes MC, Patel K. Impact of repeated reimbursement penalties on hospital total quality scores. Journal of Patient Safety. 2024. Vol. 20(3):198-201. https://doi.org/10.1097/PTS.0000000000001199
Department
School of Health Studies
Comments
The embargo period has passed because it is 12 months from when the article was first published online (which was in 2023).