Hospital credentialing and quality of care
The purpose of this study was to evaluate the impact of hospital credentialing standards on surgical outcomes for selected procedures. The study used hospital credentialing practices from a 1996 survey of North Carolina community hospitals, with surgical outcomes derived from a statewide database of...
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Published in | Social science & medicine (1982) Vol. 50; no. 1; pp. 77 - 88 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Oxford
Elsevier Ltd
2000
Elsevier Pergamon Press Inc |
Series | Social Science & Medicine |
Subjects | |
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Abstract | The purpose of this study was to evaluate the impact of hospital credentialing standards on surgical outcomes for selected procedures. The study used hospital credentialing practices from a 1996 survey of North Carolina community hospitals, with surgical outcomes derived from a statewide database of inpatient surgical discharges in 1995. Hospital mortality, complications and elevated lengths of stay were used as outcome indicators in an analysis of 6 surgical procedures. Multivariate logit analysis was used to calculate the effects of hospital credentialing stringency and nine credentialing practices on outcomes, controlling for patient demographic characteristics, type of admission, severity of illness and hospital characteristics. Teaching hospitals adopted more stringent credentialing practices, with almost no difference between metropolitan and nonmetropolitan nonteaching facilities in their use of various credentialing policies. Surgical outcomes typically were not related to stringency of the hospital credentialing environment. Generally, the effect of specific practices was inconsistent (associated with improved outcomes for certain procedures and significantly worse outcomes for others) or counterintuitive (showing
worse outcomes for selected surgical procedures where effects were statistically significant). More stringent hospital credentialing does not appear likely to improve patient outcomes. |
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AbstractList | The purpose of this study was to evaluate the impact of hospital credentialing standards on surgical outcomes for selected procedures. The study used hospital credentialing practices from a 1996 survey of North Carolina community hospitals, with surgical outcomes derived from a statewide database of inpatient surgical discharges in 1995. Hospital mortality, complications and elevated lengths of stay were used as outcome indicators in an analysis of 6 surgical procedures Evaluated the impact of hospital credentialing standards on surgical outcomes for selected procedures. The study used hospital credentialing practices from a 1996 survey of North Carolina community hospitals, with surgical outcomes derived from a statewide database of inpatient surgical discharges in 1995. (Original abstract - amended) The purpose of this study was to evaluate the impact of hospital credentialing standards on surgical outcomes for selected procedures. The study used hospital credentialing practices from a 1996 survey of North Carolina community hospitals, with surgical outcomes derived from a statewide database of inpatient surgical discharges in 1995. Hospital mortality, complications and elevated lengths of stay were used as outcome indicators in an analysis of 6 surgical procedures. Multivariate logit analysis was used to calculate the effects of hospital credentialing stringency and nine credentialing practices on outcomes, controlling for patient demographic characteristics, type of admission, severity of illness and hospital characteristics. Teaching hospitals adopted more stringent credentialing practices, with almost no difference between metropolitan and nonmetropolitan nonteaching facilities in their use of various credentialing policies. Surgical outcomes typically were not related to stringency of the hospital credentialing environment. Generally, the effect of specific practices was inconsistent (associated with improved outcomes for certain procedures and significantly worse outcomes for others) or counterintuitive (showing worse outcomes for selected surgical procedures where effects were statistically significant). More stringent hospital credentialing does not appear likely to improve patient outcomes. To evaluate the impact of hospital credentialing standards on surgical outcomes for selected procedures, data on hospital credentialing practices from a 1996 survey of NC community hospitals were analyzed in relation to surgical outcomes derived from a statewide database of inpatient surgical discharges in 1995. Hospital mortality, complications, & elevated lengths of stay were used as outcome indicators in an analysis of 6 surgical procedures. Multivariate logit analysis was used to calculate the effects of hospital credentialing stringency & nine credentialing practices on outcomes, controlling for patient demographic characteristics, type of admission, severity of illness, & hospital characteristics. Teaching hospitals adopted more stringent credentialing practices, with almost no difference between metropolitan & nonmetropolitan nonteaching facilities in their use of various credentialing policies. Surgical outcomes typically were not related to stringency of the hospital credentialing environment. Generally, the effect of specific practices was inconsistent or counterintuitive, & more stringent hospital credentialing does not appear likely to improve patient outcomes. 6 Tables, 26 References. Adapted from the source document. The purpose of this study was to evaluate the impact of hospital credentialing standards on surgical outcomes for selected procedures. The study used hospital credentialing practices from a 1996 survey of North Carolina community hospitals, with surgical outcomes derived from a statewide database of inpatient surgical discharges in 1995. Hospital mortality, complications and elevated lengths of stay were used as outcome indicators in an analysis of 6 surgical procedures. Multivariate logit analysis was used to calculate the effects of hospital credentialing stringency and nine credentialing practices on outcomes, controlling for patient demographic characteristics, type of admission, severity of illness and hospital characteristics. Teaching hospitals adopted more stringent credentialing practices, with almost no difference between metropolitan and nonmetropolitan nonteaching facilities in their use of various credentialing policies. Surgical outcomes typically were not related to stringency of the hospital credentialing environment. Generally, the effect of specific practices was inconsistent (associated with improved outcomes for certain procedures and significantly worse outcomes for others) or counterintuitive (showing worse outcomes for selected surgical procedures where effects were statistically significant). More stringent hospital credentialing does not appear likely to improve patient outcomes. |
Author | Sloan, Frank A Conover, Christopher J Provenzale, Dawn |
Author_xml | – sequence: 1 givenname: Frank A surname: Sloan fullname: Sloan, Frank A organization: Center for Health Policy, Law and Management, Sanford Institute of Public Policy, Box 90253, Duke University, Durham, NC 27708, USA – sequence: 2 givenname: Christopher J surname: Conover fullname: Conover, Christopher J organization: Center for Health Policy, Law and Management, Sanford Institute of Public Policy, Box 90253, Duke University, Durham, NC 27708, USA – sequence: 3 givenname: Dawn surname: Provenzale fullname: Provenzale, Dawn organization: Division of Gastroenterology, Department of Medicine, Duke University Medical Center; Health Services Research and Development, Durham VA Medical Center, Durham, NC 27708, USA |
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Keywords | Clinical competence Cholecystectomy Intraoperative complications Medical licensure United States Surgery Laparascopic Certification Human Postoperative Health system Evaluation Prognosis Health staff Health service Indicator Care Quality assurance Hospital organization Professional practice Quality Accreditation Public health |
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Title | Hospital credentialing and quality of care |
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