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Processes of care and outcomes for community-acquired pneumonia

Lee, JS and Primack, BA and Mor, MK and Stone, RA and Obrosky, DS and Yealy, DM and Fine, MJ (2011) Processes of care and outcomes for community-acquired pneumonia. American Journal of Medicine, 124 (12). ISSN 0002-9343

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Abstract

Background: Although processes of care are common proxies for health care quality, their associations with medical outcomes remain uncertain. Methods: For 2076 patients hospitalized with pneumonia from 32 emergency departments, we used multilevel logistic regression modeling to assess independent associations between patient outcomes and the performance of 4 individual processes of care (assessment of oxygenation, blood cultures, and rapid initiation [<4 hours] and appropriate selection of antibiotic therapy) and the cumulative number of processes of care performed. Results: Overall, 141 patients (6.8%) died. Mortality was 0.3% to 1.7% lower for patients who had each of the individual processes of care performed (P <.13 for each comparison); mortality was 7.5% for patients who had 0 to 2 processes of care, 7.2% for those with 3 processes of care, and 5.8% for those with all 4 processes of care performed (P =.39). Mortality was not significantly associated with either individual or cumulative process measures in multivariable models. Conclusion: Neither the individual processes of care nor the cumulative number performed is associated with short-term mortality for pneumonia. ©.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Lee, JS
Primack, BAbprimack@pitt.eduBPRIMACK
Mor, MKmariamor@pitt.eduMARIAMOR
Stone, RAroslyn@pitt.eduROSLYN
Obrosky, DSdsoport@pitt.eduDSOPORT
Yealy, DMdmy@pitt.eduDMY
Fine, MJmjf1@pitt.eduMJF1
Centers: Other Centers, Institutes, Offices, or Units > Center for Research on Media, Technology, and Health
Date: 1 December 2011
Date Type: Publication
Journal or Publication Title: American Journal of Medicine
Volume: 124
Number: 12
DOI or Unique Handle: 10.1016/j.amjmed.2011.05.029
Schools and Programs: Graduate School of Public Health > Biostatistics
School of Medicine > Emergency Medicine
School of Medicine > Medicine
School of Medicine > Pediatrics
Refereed: Yes
ISSN: 0002-9343
MeSH Headings: Adult; Aged; Anti-Infective Agents--therapeutic use; Chi-Square Distribution; Community-Acquired Infections--mortality; Community-Acquired Infections--therapy; Connecticut--epidemiology; Evidence-Based Medicine; Female; Guideline Adherence; Hospital Mortality; Humans; Logistic Models; Male; Middle Aged; Outcome and Process Assessment (Health Care); Pennsylvania--epidemiology; Pneumonia--mortality; Pneumonia--therapy; Prognosis; Risk Factors; Severity of Illness Index; Statistics, Nonparametric
Other ID: NLM NIHMS387883, NLM PMC3578284
PubMed Central ID: PMC3578284
PubMed ID: 22000624
Date Deposited: 28 Jul 2014 16:47
Last Modified: 23 Jun 2018 20:55
URI: http://d-scholarship.pitt.edu/id/eprint/22393

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