Skip to main content

Identifying Top-Performing Hospitals by Algorithm: Results from a Demonstration Project

Buy Article:

$12.00 plus tax (Refund Policy)

Abstract:

Background: Because of the move toward performance-based reimbursement, identification of top-performing hospitals has acquired new importance.

Methods: The High Performance Algorithm (HPA) for hospitals was developed on the basis of the following principles: (1) the approach must be data driven and transparent, (2) all hospitals providing the same service are held to the same standard, (3) top-performing hospitals must perform well on easily achieved and difficult quality measures, and (4) high performance demands sustained excellence over time. The HPA algorithm was applied to 16 quality measures from the national Hospital Quality Alliance (July 2003–June 2004) for acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Top-performing hospitals were defined as those with the top 1% of HPA scores (n = 45).

Results: From all 3,867 hospitals, median HPA scores (interquartile range) were 17.0 (16.0–19.0) for top-performing hospitals and 3.0 (1.0–6.0) for others (p < .001). Mean performance on quality measures was higher for top hospitals on all 16 measures. For example, on administration of angiotensin-converting enzyme inhibitors to patients with HF, the mean score for top-performing hospitals was 93.3%, compared with 76.5% for others (p < .001). Although many hospitals achieved excellence on individual measures, sustained top performance across multiple conditions and time periods was uncommon, with < 1% of hospitals scoring ≥ 16/36 points on the HPA scale.

Discussion: Using national, publicly reported data, the HPA provided good discrimination between top-performing and other hospitals. This project sets the stage for future comparisons of organizational, leadership, and policy differences between top-performing and other hospitals.

Document Type: Research Article

Publication date: 2008-06-01

More about this publication?
  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect (http://www.sciencedirect.com/science/journal/15537250). For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit www.myelsevier.com for more information. All other readers, please visit http://www.jointcommissionjournal.com/ to subscribe to the journal or to claim your access for an existing subscription.
  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • Information for Advertisers
  • Reprints and Permissions
  • Index
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free ContentFree content
  • Partial Free ContentPartial Free content
  • New ContentNew content
  • Open Access ContentOpen access content
  • Partial Open Access ContentPartial Open access content
  • Subscribed ContentSubscribed content
  • Partial Subscribed ContentPartial Subscribed content
  • Free Trial ContentFree trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more