Association between Accreditation and In-Hospital Mortality in Patients with Major Cardiovascular Diseases in South Korean Hospitals: Pre-Post Accreditation Comparison
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources and Study Population
2.2. Variables and Definitions
2.3. Analyses
3. Results
4. Discussion
4.1. Main Findings
4.2. Strengths of This Study
4.3. Comparison with Previous Studies
4.4. Limitations of This Study
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Acute Myocardial Infarction | Ischemic Stroke | Hemorrhagic Stroke | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pre Accreditation n = 20,512 | Post Accreditation n = 26,766 | Pre Accreditation n = 64,553 | Post Accreditation n = 79,034 | Pre Accreditation n = 26,602 | Post Accreditation n = 31,202 | ||||||||
Patient | |||||||||||||
Sex | Male | 15,677 | (76.43) | 20,919 | (78.16) | 38,903 | (60.27) | 48,233 | (61.03) | 15,124 | (56.85) | 17,435 | (55.88) |
Female | 4835 | (23.57) | 5847 | (21.84) | 25,650 | (39.73) | 30,801 | (38.97) | 11,478 | (43.15) | 13,767 | (44.12) | |
Age | <50 | 2235 | (10.90) | 3701 | (13.83) | 4074 | (6.31) | 6251 | (7.91) | 5189 | (19.51) | 6881 | (22.05) |
50–64 | 8048 | (39.24) | 11,061 | (41.32) | 18,940 | (29.34) | 24,914 | (31.52) | 10,365 | (38.96) | 12,557 | (40.24) | |
65+ | 10,229 | (49.87) | 12,004 | (44.85) | 41,539 | (64.35) | 47,869 | (60.57) | 11,048 | (41.53) | 11,764 | (37.70) | |
Insurance Type | Medical aid | 1522 | (7.42) | 1667 | (6.23) | 7590 | (11.76) | 7399 | (9.36) | 3272 | (12.30) | 2932 | (9.40) |
Insurance | 18,990 | (92.58) | 25,099 | (93.77) | 56,963 | (88.24) | 71,635 | (90.64) | 23,330 | (87.70) | 28,270 | (90.60) | |
Charlson comorbidity index | 0 | 16,642 | (81.13) | 21,723 | (81.16) | 47,335 | (73.33) | 59,514 | (75.30) | 20,859 | (78.41) | 24,868 | (79.70) |
1 | 3658 | (17.83) | 4781 | (17.86) | 14,656 | (22.70) | 16,790 | (21.24) | 4584 | (17.23) | 5186 | (16.62) | |
2 | 212 | (1.03) | 262 | (0.98) | 2562 | (3.97) | 2730 | (3.45) | 1159 | (4.36) | 1148 | (3.68) | |
Admission Type | via emergency room | 13,594 | (66.27) | 18,014 | (67.30) | 30,263 | (46.88) | 38,048 | (48.14) | 16,646 | (62.57) | 19,814 | (63.50) |
via outpatient care | 6918 | (33.73) | 8752 | (32.70) | 34,290 | (53.12) | 40,986 | (51.86) | 9956 | (37.43) | 11,388 | (36.50) | |
Hospital | |||||||||||||
Workforce per 100 beds | No. of physician | 31.91 | 31.98 | 29.07 | 28.89 | 32.07 | 31.54 | ||||||
No. of nurses | 88.38 | 88.63 | 80.93 | 80.97 | 85.34 | 85.04 | |||||||
Ownership | Public | 2121 | (10.34) | 2468 | (9.22) | 8770 | (13.59) | 9988 | (12.64) | 3355 | (12.61) | 3712 | (11.90) |
Corporate | 17,154 | (83.63) | 22,636 | (84.57) | 50,853 | (78.78) | 61,716 | (78.09) | 21,364 | (80.31) | 24,705 | (79.18) | |
Individual | 1237 | (6.03) | 1662 | (6.21) | 4930 | (7.64) | 7330 | (9.27) | 1883 | (7.08) | 2785 | (8.93) | |
Region | Metropolitan | 9298 | (45.33) | 12,847 | (48.00) | 29,829 | (46.21) | 36,559 | (46.26) | 13,361 | (50.23) | 15,349 | (49.19) |
Nonmetropolitan | 11,214 | (54.67) | 13,919 | (52.00) | 34,724 | (53.79) | 42,475 | (53.74) | 13,241 | (49.77) | 15,853 | (50.81) |
30-Day Mortality before Accreditation | 30-Day Mortality after Accreditation | |||||
---|---|---|---|---|---|---|
3 Years before | 2 Years before | 1 Year before | 1 Year after | 2 Years after | 3 Years after | |
Acute myocardial infarction | 510/6730 (7.58%) | 485/6566 (7.39%) | 530/7216 (7.34%) | 523/7997 (6.54%) | 488/8646 (5.64%) | 635/10,123 (6.27%) |
Ischemic stroke | 880/19,209 (4.58%) | 1064/22,231 (4.79%) | 1050/23,113 (4.54%) | 1011/24,317 (4.16%) | 947/25,939 (3.65%) | 1049/28,778 (3.65%) |
Hemorrhagic stroke | 1643/8010 (20.51%) | 1661/9261 (17.94%) | 1624/9331 (17.40%) | 1654/9545 (17.33%) | 1603/10,177 (15.75%) | 1677/11,480 (14.61%) |
Acute Myocardial Infarction | Ischemic Stroke | Hemorrhagic Stroke | ||||
---|---|---|---|---|---|---|
Domain | Adjusted Odds Ratio * | 95% Confidence Interval | Adjusted Odds Ratio * | 95% Confidence Interval | Adjusted Odds Ratio * | 95% Confidence Interval |
Achieving the patient care domain (vs. not achieving) | 0.162 | 0.035–0.760 | 0.539 | 0.186–1.559 | 0.354 | 0.128–0.983 |
Achieving the administrative domain (vs. not achieving) | 0.802 | 0.369–1.744 | 1.444 | 0.882–2.364 | 1.331 | 0.846–2.095 |
Achieving the performance management domain (vs. not achieving) | 0.540 | 0.299–0.975 | 0.975 | 0.576–1.652 | 0.529 | 0.360–0.779 |
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Chun, Y.J.; Lee, B.Y.; Lee, Y.H. Association between Accreditation and In-Hospital Mortality in Patients with Major Cardiovascular Diseases in South Korean Hospitals: Pre-Post Accreditation Comparison. Medicina 2020, 56, 436. https://doi.org/10.3390/medicina56090436
Chun YJ, Lee BY, Lee YH. Association between Accreditation and In-Hospital Mortality in Patients with Major Cardiovascular Diseases in South Korean Hospitals: Pre-Post Accreditation Comparison. Medicina. 2020; 56(9):436. https://doi.org/10.3390/medicina56090436
Chicago/Turabian StyleChun, You Jin, Bo Yeon Lee, and Yo Han Lee. 2020. "Association between Accreditation and In-Hospital Mortality in Patients with Major Cardiovascular Diseases in South Korean Hospitals: Pre-Post Accreditation Comparison" Medicina 56, no. 9: 436. https://doi.org/10.3390/medicina56090436