Kroch hospperformimprove figures ppt

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Figure ES-1. Select Practice* over Time
Percent of hospitals
Year 1
Year 2
Year 3
30
24.8
25
21.7
20
14.8
16.1 16.3
15
14.0
19.5
16.2
11.2
10
5
0
State All-Payer
MedPAR
Database
* Hospitals in the top two quintiles for both quality and efficiency.
Source: Authors’ analysis.
CareScience
Figure ES-2. Percent of High-Efficiency Hospitals* over Time
Percent of hospitals
Year 1
60
Year 3
52.6
50
40
Year 2
40.5
43.4
35.3
51.7
45.0
44.8
38.9
35.8
30
20
10
0
State All-Payer
MedPAR
CareScience
Database
* Hospitals whose risk-adjusted average length of stay is in the lowest two quintiles.
Source: Authors’ analysis.
Figure ES-3. Quality Improvement* over Time
in Case Study Hospitals
Quality percentile
100
80
81
91
2002
2003
98
2004
92
64
58
60
89
62
41
40
20
8
11
8
0
Beth Israel
Legacy Good
Rankin Medical
St. Mary’s
Medical Center
Samaritan
Center
Health Care
Hospital
Case Study Hospital
* Trend in percentile ranking (percent of hospitals with a lower quality score).
Source: Authors’ analysis.
System
Figure 2. Mean Risk-Adjusted Mortality by Database
Risk-adjusted mortality rate
State All-Payer
MedPAR
CareScience Private
%
7
6
5
4
3
2
1
0
2001
2002
2003
Year
2004
2005
Figure 3. Mean Risk-Adjusted Length of Stay by Database
Risk-adjusted LOS (days)
State All-Payer
MedPAR
CareScience Private
5
4
3
2
2001
2002
2003
Year
2004
2005
Figure 4. Mean Risk-Adjusted Complication Rate by Database
Risk-adjusted complication rate
State All-Payer
MedPAR
CareScience Private
%
44
42
40
38
36
34
32
2001
2002
2003
Year
2004
2005
Figure 5. Mean Risk-Adjusted Morbidity Rate by Database
Risk-adjusted morbidity rate
State All-Payer
MedPAR
CareScience Private
%
14
13
12
11
10
9
8
7
6
2001
2002
2003
Year
2004
2005
Figure 6. Dispersion in Risk-Adjusted Mortality Rates
over Time
MedPAR risk-adjusted mortality rate
Bottom quintile (highest rate)
Median
%
Top quintile (lowest rate)
7
6
5
4
3
2
1
0
2001
2002
2003
Year
2004
2005
Figure 7. Dispersion in Risk-Adjusted Complication Rates
over Time
MedPAR risk-adjusted complication rate
Bottom quintile (highest rate)
Median
%
Top quintile (lowest rate)
48
46
44
42
40
38
36
34
2001
2002
2003
Year
2004
2005
Figure 8. Dispersion in Risk-Adjusted Morbidity Rates
over Time
MedPAR risk-adjusted morbidity rate
Bottom quintile (highest rate)
Median
%
Top quintile (lowest rate)
15
14
13
12
11
10
9
8
2001
2002
2003
Year
2004
2005
Figure 9. Dispersion in Risk-Adjusted Length of Stay
over Time
MedPAR risk-adjusted LOS (days)
Bottom quintile (highest rate)
Median
Top quintile (lowest rate)
6
5
4
3
2
2001
2002
2003
Year
2004
2005
Figure 10. Starting Point Distribution for
100 Most-Improving Hospitals
Starting percentile
MedPAR—Efficiency
>90
State All-Payer—Efficiency
80–90
MedPAR—Quality
70–80
State All-Payer—Quality
60–70
50–60
40–50
30–40
20–30
10–20
<10
0
10
20
30
40
50
Percent of 100 Most-Improving Hospitals
60
Figure 11. Starting Point Distribution for
100 Most-Deteriorating Hospitals
Starting percentile
>90
80–90
70–80
MedPAR—Efficiency
60–70
State All-Payer—Efficiency
50–60
MedPAR—Quality
State All-Payer—Quality
40–50
30–40
20–30
10–20
<10
0
10
20
30
Percent of 100 Most-Deteriorating Hospitals
40
Figure 12. Hospital Size by Performance Level
Discharges per year
100 most-improving hospitals
All hospitals
100 most-deteriorating hospitals
16000
14000
12000
10000
8000
6000
4000
2000
0
State All-Payer
Quality
MedPAR
Quality
State All-Payer
Efficiency
Quality/Efficiency by Database
MedPAR
Efficiency
Figure 13. Hospital Teaching Status by Performance Level
Percent major teaching institution
100 most-improving hospitals
All hospitals
100 most-deteriorating hospitals
%
40
30
20
10
0
State All-Payer
Quality
MedPAR
Quality
State All-Payer
Efficiency
Quality/Efficiency by Database
MedPAR
Efficiency
Figure 14. Raw Mortality and Mortality Risk Trends
Quarterly mortality—case-weighted means
%
Risk
Linear (Risk)
2.6
Raw
Linear (Raw)
2.5
2.4
2.3
2.2
2.1
2.0
1.9
2003
q2
q3
q4
2004
q2
q3
Year
Source: CareScience private data.
q4
2005
q2
q3
q4
Figure 15. Discharge Disposition Trend
Percent of total discharges
Short-term general hospital
Other institution
Expired
%
12
Skilled nursing facility
Home with help
10
8
6
4
2
0
2003
q2
q3
q4
2004
q2
q3
Year
Source: CareScience private data.
q4
2005
q2
q3
q4
Figure 16. Secondary Diagnosis Trend
Number of secondary diagnoses per case
7.0
6.5
6.0
5.5
5.0
2003
q2
q3
q4
2004
q2
q3
Year
Source: CareScience private data.
q4
2005
q2
q3
q4
Figure 17. Private Data: Readmission Rate by Quarter
Rate
%
10.0
9.8
9.6
9.4
9.2
9.0
2003
q3
q4
2004
q2
q3
Year
Source: CareScience private data.
q4
2005
q2
q3
q4

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