The Association Between Hospital Characteristics and Rates of Preventable Complications and Adverse Events

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Abstract
This study examined the statistical relationship between hospital ownership and teaching status and hospital rates for potentially preventable adverse events measured using patient safety indicators recently developed by the Agency for Healthcare Research and Quality. RESEARCH DESIGN/MEASURES: A nationally representative sample of hospitals grouped into mutually exclusive combinations of control/ownership, teaching status, and rurality was defined using the Nationwide Inpatient Sample data set for the year 2000. Hospital rates for 5 categories of preventable adverse events were measured in 3 forms: unadjusted, risk-adjusted, and risk-adjusted ratios with smoothing. Multivariable regression analysis was used to measure the statistical significance of the relationship between hospital type and rates for potentially preventable adverse events, with adjustments for differences in hospital bed size and region. This analysis found an inconsistent relationship between categories of hospital type and quality care measured by alternative indicators of potentially preventable conditions. Hospital ownership and teaching status is not a consistent predictor of differences in rates of potentially preventable adverse events, and these characteristics explain little of the observed variation in the rates of these events across hospitals.