Rethinking Measures and Mortality Attribution in Health Care: The Diabetes and Endocrinology Example.

Autor:	Olivero L; Department of Critical Care, Mayo Clinic, Jacksonville, FL.; Department of Internal Medicine, Jacobi Medical Center, New York, NY., Sinclair J; Department of Critical Care, Mayo Clinic, Jacksonville, FL.; Department of Internal Medicine, Mount Sinai Morningside and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY., Singh T; Department of Critical Care, Mayo Clinic, Jacksonville, FL.; Department of Internal Medicine, Texas Tech University Health Sciences Center, Odessa, TX.; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL., Khanijo AA; Department of Critical Care, Mayo Clinic, Jacksonville, FL., Mundhra G; Department of Critical Care, Mayo Clinic, Jacksonville, FL.; Department of Internal Medicine, HCA Florida Orange Park Hospital, Jacksonville, FL., Chindris AM; Department of Endocrinology, Diabetes and Metabolism, Mayo Clinic, Jacksonville, FL., Menser T; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL., Franco PM; Department of Critical Care, Mayo Clinic, Jacksonville, FL.; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL.; Department of Internal Medicine, Mayo Clinic, Jacksonville, FL., Pollock BD; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL., Chirila RM; Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings. Innovations, quality & outcomes [Mayo Clin Proc Innov Qual Outcomes] 2024 Sep 06; Vol. 8 (5), pp. 475-479. Date of Electronic Publication: 2024 Sep 06 (Print Publication: 2024).
DOI:	10.1016/j.mayocpiqo.2024.08.001
Abstrakt:	This study investigated the accuracy of mortality attributions assigned by the US News and World Report (USNWR) to the diabetes and endocrinology specialty. We reviewed medical records of all consecutive Medicare fee-for-service inpatients at Mayo Clinic, Florida (Jacksonville, Florida) with a Medicare Severity Diagnosis Related Group included in the USNWR Diabetes & Endocrinology specialty cohort admitted from November 2018 to April 2022, with documented mortality in our institution's electronic health record within 30 days of the index admission. A clinician adjudicated the primary cause of death, categorizing it as diabetes or endocrine, cancer, failure to thrive, or other. Among 49 deceased patients, only 7 (14.3%) had diabetes or an endocrine-related cause of death. Cancer (49.0%) and failure to thrive (30.6%) were the leading causes. This substantial discrepancy (86% misattribution) suggests USNWR's methodology might not precisely reflect the quality of care, potentially misleading patients and impacting hospital rankings. Competing Interests: The authors report no competing interests. (© 2024 The Authors.)
Databáze:	MEDLINE
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