Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.

<h4>Background</h4>In New York City (NYC), pneumonia is a leading cause of death and most pneumonia deaths occur in hospitals. Whether the pneumonia death rate in NYC reflects reporting artifact or is associated with factors during pneumonia-associated hospitalization (PAH) is unknown. W...

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Autores principales: Kate Whittemore, Kristian M Garcia, Chaorui C Huang, Sungwoo Lim, Demetre C Daskalakis, Neil M Vora, David E Lucero
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:086b28f693f4420e837af5cbb3fdceeb2021-12-02T20:13:48ZHospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.1932-620310.1371/journal.pone.0256678https://doaj.org/article/086b28f693f4420e837af5cbb3fdceeb2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256678https://doaj.org/toc/1932-6203<h4>Background</h4>In New York City (NYC), pneumonia is a leading cause of death and most pneumonia deaths occur in hospitals. Whether the pneumonia death rate in NYC reflects reporting artifact or is associated with factors during pneumonia-associated hospitalization (PAH) is unknown. We aimed to identify hospital-level factors associated with higher than expected in-hospital pneumonia death rates among adults in NYC.<h4>Methods</h4>Data from January 1, 2010-December 31, 2014 were obtained from the New York Statewide Planning and Research Cooperative System and the American Hospital Association Database. In-hospital pneumonia standardized mortality ratio (SMR) was calculated for each hospital as observed PAH death rate divided by expected PAH death rate. To determine hospital-level factors associated with higher in-hospital pneumonia SMR, we fit a hospital-level multivariable negative binomial regression model.<h4>Results</h4>Of 148,172 PAH among adult NYC residents in 39 hospitals during 2010-2014, 20,820 (14.06%) resulted in in-hospital death. In-hospital pneumonia SMRs varied across NYC hospitals (0.77-1.23) after controlling for patient-level factors. An increase in average daily occupancy and membership in the Council of Teaching Hospitals were associated with increased in-hospital pneumonia SMR.<h4>Conclusions</h4>Differences in in-hospital pneumonia SMRs between hospitals might reflect differences in disease severity, quality of care, or coding practices. More research is needed to understand the association between average daily occupancy and in-hospital pneumonia SMR. Additional pneumonia-specific training at teaching hospitals can be considered to address higher in-hospital pneumonia SMR in teaching hospitals.Kate WhittemoreKristian M GarciaChaorui C HuangSungwoo LimDemetre C DaskalakisNeil M VoraDavid E LuceroPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0256678 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Kate Whittemore
Kristian M Garcia
Chaorui C Huang
Sungwoo Lim
Demetre C Daskalakis
Neil M Vora
David E Lucero
Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.
description <h4>Background</h4>In New York City (NYC), pneumonia is a leading cause of death and most pneumonia deaths occur in hospitals. Whether the pneumonia death rate in NYC reflects reporting artifact or is associated with factors during pneumonia-associated hospitalization (PAH) is unknown. We aimed to identify hospital-level factors associated with higher than expected in-hospital pneumonia death rates among adults in NYC.<h4>Methods</h4>Data from January 1, 2010-December 31, 2014 were obtained from the New York Statewide Planning and Research Cooperative System and the American Hospital Association Database. In-hospital pneumonia standardized mortality ratio (SMR) was calculated for each hospital as observed PAH death rate divided by expected PAH death rate. To determine hospital-level factors associated with higher in-hospital pneumonia SMR, we fit a hospital-level multivariable negative binomial regression model.<h4>Results</h4>Of 148,172 PAH among adult NYC residents in 39 hospitals during 2010-2014, 20,820 (14.06%) resulted in in-hospital death. In-hospital pneumonia SMRs varied across NYC hospitals (0.77-1.23) after controlling for patient-level factors. An increase in average daily occupancy and membership in the Council of Teaching Hospitals were associated with increased in-hospital pneumonia SMR.<h4>Conclusions</h4>Differences in in-hospital pneumonia SMRs between hospitals might reflect differences in disease severity, quality of care, or coding practices. More research is needed to understand the association between average daily occupancy and in-hospital pneumonia SMR. Additional pneumonia-specific training at teaching hospitals can be considered to address higher in-hospital pneumonia SMR in teaching hospitals.
format article
author Kate Whittemore
Kristian M Garcia
Chaorui C Huang
Sungwoo Lim
Demetre C Daskalakis
Neil M Vora
David E Lucero
author_facet Kate Whittemore
Kristian M Garcia
Chaorui C Huang
Sungwoo Lim
Demetre C Daskalakis
Neil M Vora
David E Lucero
author_sort Kate Whittemore
title Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.
title_short Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.
title_full Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.
title_fullStr Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.
title_full_unstemmed Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.
title_sort hospital-level factors associated with death during pneumonia-associated hospitalization among adults-new york city, 2010-2014.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/086b28f693f4420e837af5cbb3fdceeb
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AT chaoruichuang hospitallevelfactorsassociatedwithdeathduringpneumoniaassociatedhospitalizationamongadultsnewyorkcity20102014
AT sungwoolim hospitallevelfactorsassociatedwithdeathduringpneumoniaassociatedhospitalizationamongadultsnewyorkcity20102014
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AT neilmvora hospitallevelfactorsassociatedwithdeathduringpneumoniaassociatedhospitalizationamongadultsnewyorkcity20102014
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