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Am J Med. 2011 Dec;124(12):1175.e9-17. doi: 10.1016/j.amjmed.2011.05.029. Epub 2011 Oct 13.

Processes of care and outcomes for community-acquired pneumonia.

Author information

1
Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, USA.

Abstract

BACKGROUND:

Although processes of care are common proxies for health care quality, their associations with medical outcomes remain uncertain.

METHODS:

For 2076 patients hospitalized with pneumonia from 32 emergency departments, we used multilevel logistic regression modeling to assess independent associations between patient outcomes and the performance of 4 individual processes of care (assessment of oxygenation, blood cultures, and rapid initiation [<4 hours] and appropriate selection of antibiotic therapy) and the cumulative number of processes of care performed.

RESULTS:

Overall, 141 patients (6.8%) died. Mortality was 0.3% to 1.7% lower for patients who had each of the individual processes of care performed (P≥.13 for each comparison); mortality was 7.5% for patients who had 0 to 2 processes of care, 7.2% for those with 3 processes of care, and 5.8% for those with all 4 processes of care performed (P=.39). Mortality was not significantly associated with either individual or cumulative process measures in multivariable models.

CONCLUSION:

Neither the individual processes of care nor the cumulative number performed is associated with short-term mortality for pneumonia.

PMID:
22000624
PMCID:
PMC3578284
DOI:
10.1016/j.amjmed.2011.05.029
[Indexed for MEDLINE]
Free PMC Article
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