Top 100 hospitals form clinical research group
Top 100 hospitals form clinical research group
First study analyzes antibiotic treatment
For the past six years, HCIA Inc. in Baltimore has produced its list of the 100 Top Hospitals, and many of those facilities have become targets for benchmarking by their peers who didn’t make the list. That’s exactly the point, says HCIA senior vice president Jean Chenoweth, but the lack of more detailed publicly available data has made it difficult for even the list makers themselves to identify what sets them apart.
Not anymore. HCIA and past award winners of the 100 Top Hospitals citation have joined forces to create a clinical research program with the goal of expanding medical knowledge beyond the limits of publicly available UB-92 files, she says. The 100 Top Hospitals: Clinical Research Program will produce three national research studies each year in the hopes of establishing first-ever national benchmarks from performance-based treatment data.
"This is a whole new level of medical research," Chenoweth says.
The recently completed first study analyzed the patient and hospital factors that contribute to the use of prophylactic antibiotic treatment (PAT) in preventing postoperative wound infections in clean surgical cases. she says it was the first study on PAT that covers a wide range of surgical procedures — 24 diagnosis-related groups were included — and that is based on more than 200,000 patients across the nation. The study compared overall PAT use across the United States as well as usage patterns between the top 100 hospitals and the rest of the nation’s hospitals. Data were examined at both the hospital and patient levels, and comparisons were made on charges, wound infection rates, lengths of stay, and illness severity.
The result: The 100 Top Hospitals used PAT more selectively than their peer hospitals — by about 4.7 patients per 100 — with no significant difference in clinical results and at a significantly lower cost. The mean charge at the 100 Top Hospitals was $16,730, compared with $19,511 for the peer group. First-generation cephalosporins were the drug of choice for both the 100 Top Hospitals and their peers, but the peer hospitals were more likely to use second- and third-generation cephalosporins as well.
"We wanted to do a definitive study. It’s hard to determine what is the right thing to do on this issue because all the studies have been so narrow. We showed that hospitals with lower costs are not giving worse care. They are selective, and they have the same outcomes," Chenoweth says.
The group’s next study, due in the fall, will examine PAT usage at a finer level of detail by procedure.
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