Health Research & Educational Trust of New Jersey (HRET)
Research
Ongoing Projects
Comparative Clinical Outcomes
Since 1995, HRET has prepared an annual a series of comparative data on certain quality measures to help hospitals identify opportunities to improve the quality of care rendered to their communities. The data presented in this report are derived from the New Jersey Uniform Bill-Patient Summary (UB-PS) data that is collected by the New Jersey Discharge Data Collection System for all inpatients discharged from acute care hospitals in New Jersey.
The quality and outcomes measures included in this report are selected from a variety of sources, including the National Hospital Quality Measures - the Centers for Medicare and Medicaid Services and The Joint Commission’s required surgical infection prevention measures, the Agency for Healthcare Research and Quality’s Inpatient Quality Indicators and Patient Safety Indicators and the QuadraMed performance measures. As of 2007, the following topics are included in this report:
- Myocardial Infarction Mortality
- Heart Failure Mortality
- Pneumonia Mortality
- Postoperative Infections for Surgical Inpatients
The definition and method of calculating rates for each topic are described in the report. The risk-adjustment methodology employed accounts or controls for patient characteristics and conditions that are clinically meaningful and have demonstrated a statistical effect on the rates for each condition. This helps compare rates across different hospitals while controlling the effect of treating a group of patients who may be more severely ill or more likely to have a specific outcome than patients treated at other hospitals.
The data provided for each outcomes measure include the actual unadjusted raw rates for three to five years of data for each outcomes measure and the risk-adjusted predicted rate of the most recent year. The predicted rates represent the mid-point of the predicted range at a confidence level of 95 percent. A symbol is used to represent the difference between a hospital's actual rate and its predicted rate for each year.
Also included in each year are the mean rates for all hospitals in the state as well as for various peer group categories. These rates provide an opportunity for hospitals to benchmark and assist in comparative evaluation of hospital outcomes.
These data, reported for all NJHA member hospitals, are also available on NJHA’s site at
http://www.njhospitalcarecompare.com which publicly reports data on measures of healthcare quality and outcomes.
The best way to utilize the Comparative Clinical Outcomes Report (CCOR) is to integrate it into the hospital's quality improvement efforts. The report may help in identifying the areas that:
- May require improvement in the quality of care provided or the process through which the care is delivered;
- Offer examples of especially good processes of care that can be used as a model to improve other processes; and,
- Require improvement in coding procedures, the development of consistent coding guidelines or improvement in documentation of care actually rendered.
All hospitals are now familiar with the data released through CCOR and many are using the longitudinal report of actual rates and risk-adjusted predicted rates to improve their patient outcomes.
Please note, for certain indicators the definitions and prediction models have been changed over time. For example, the AHRQ definition and model were used for 2006 pneumonia mortality released in 2007, and therefore, this data should not be compared with the data reported on this topic in previous years that used a different definition and prediction model. Each year’s report includes information about all such changes.
This report is distributed only to hospital CEOs and QA executives due to confidentiality of the included data.