Impact of Hospital Characteristics on Surgical Outcomes and Length of Stay

摘要

Two sets of data were used: an extensive study of the 1225 hospitals in the 1972 PAS of the CPHA and 559,629 patients in 17 diagnostic categories; and an intensive study of 17 randomly selected hospitals with 8,593 associated surgical patients in 15 diagnostic-operation categories. Outcomes were hospital death and measures of length of stay in the extensive study; and 7th postoperative day morbidity and 40th day mortality for the intensive study. Scales were developed to assess relative complexity and uncertainty of selected procedures performed by surgeons and nurses. Hospitals varied significantly in quality of care after adjustment for patient differences. Analysis of LOS, adjusted for patient differences, showed highly significant hospital differences for total and post-surgical LOS. The combined power of organizational variables to explain variance in adjusted outcomes was very low. Levels of explained variance were higher for LOS and hospital performance measures.