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

{"title":"Rethinking Measures and Mortality Attribution in Health Care: The Diabetes and Endocrinology Example","authors":"","doi":"10.1016/j.mayocpiqo.2024.08.001","DOIUrl":null,"url":null,"abstract":"<div><p>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 &amp; 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.</p></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542454824000535/pdfft?md5=13e13dc82a20e1c13a4b590ae2b0c6c8&pid=1-s2.0-S2542454824000535-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Mayo Clinic proceedings. Innovations, quality & outcomes","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2542454824000535","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

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.

重新思考医疗保健中的措施和死亡率归因:糖尿病与内分泌学实例
本研究调查了《美国新闻与世界报道》(USNWR)为糖尿病和内分泌专科指定的死亡率归因的准确性。我们查阅了佛罗里达州梅奥诊所(佛罗里达州杰克逊维尔市)所有连续医保付费服务住院患者的病历,这些患者的医保严重程度诊断相关组均包含在《美国新闻与世界报道》糖尿病与amp; 内分泌专科队列中,入院时间为2018年11月至2022年4月,并在索引入院后30天内在本机构的电子病历中记录有死亡病例。临床医生对主要死因进行了判定,将其归类为糖尿病或内分泌、癌症、发育不全或其他。在 49 名死亡患者中,只有 7 人(14.3%)的死因与糖尿病或内分泌有关。癌症(49.0%)和发育不良(30.6%)是主要死因。这一巨大差异(86%的错误归因)表明,USNWR的方法可能无法准确反映医疗质量,从而可能误导患者并影响医院排名。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
自引率
0.00%
发文量
0
审稿时长
49 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信