Mortality Linked to Hospital Volume in Acute Conditions

For heart attack, heart failure and pneumonia, higher volume means lower mortality - up to a point
By Jeff Muise
HealthDay Reporter

WEDNESDAY, March 24 (HealthDay News) -- Mortality for acute myocardial infarction, heart failure, and pneumonia is generally reduced in hospitals that handle more patients with those conditions, but there is a point of diminishing returns, according to research published in the March 25 issue of the New England Journal of Medicine.

Joseph S. Ross, M.D., of the Mount Sinai School of Medicine in New York City, and colleagues analyzed Medicare claims for fee-for-service beneficiaries hospitalized from 2004 to 2006 for heart failure, myocardial infarction, or pneumonia. The researchers correlated the odds for death within 30 days against 100-patient incremental increases in hospital volume (adjusted for patient risk and hospital characteristics), and determined volume thresholds above which mortality no longer was reduced.

The researchers found that 30-day mortality for all three conditions decreased as hospital volume increased, but the effect gradually attenuated until condition-specific thresholds were reached. The effect was no longer significant beyond volumes of 610 patients for myocardial infarction, 500 patients for heart failure, and 210 patients for pneumonia.

"Despite this association between hospital volume and mortality, we observed heterogeneity among the hospitals. Many patients who were admitted to low-volume hospitals had excellent outcomes, whereas many other patients who were admitted to high-volume hospitals had poor outcomes. For medical conditions, volume alone does not appear to be a proxy for hospital outcome," the authors write.

Several study authors reported receiving consulting fees from various health plans, as well as consulting fees and research grants from pharmaceutical companies.

Abstract
Full Text (subscription or payment may be required)

Copyright © 2010 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95


The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95


Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.


Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.


Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events