A study published in Neurology calls into question the validity of a quality measure that measures 30-day risk-adjusted stroke mortality.
The measure is currently being developed for use under healthcare reform, but hospitals have already adopted the measure to demonstrate their performance and quality of services. The study evaluated 436 stroke patients admitted to Strong Memorial Hospital in Rochester, N.Y., in 2009 with a diagnosis of ischemic stroke. Of that number, 37 (7.8 percent) either died within 30 days while in the hospital or were discharged to hospice care. Of that number, 36 patients died because of a decision by the patient or family to withhold or withdraw life-sustaining interventions.
The study authors then asked a panel of neurologists to determine whether deceased patients would have survived longer than 30 days if every available medical intervention were employed on a continuous basis. The panel determined that 41 percent of the patients could have been kept alive, effectively reducing the hospital's mortality rate by 3.2 percent.
The measure is currently being developed for use under healthcare reform, but hospitals have already adopted the measure to demonstrate their performance and quality of services. The study evaluated 436 stroke patients admitted to Strong Memorial Hospital in Rochester, N.Y., in 2009 with a diagnosis of ischemic stroke. Of that number, 37 (7.8 percent) either died within 30 days while in the hospital or were discharged to hospice care. Of that number, 36 patients died because of a decision by the patient or family to withhold or withdraw life-sustaining interventions.
The study authors then asked a panel of neurologists to determine whether deceased patients would have survived longer than 30 days if every available medical intervention were employed on a continuous basis. The panel determined that 41 percent of the patients could have been kept alive, effectively reducing the hospital's mortality rate by 3.2 percent.
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