Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.

Hospital-level factors associated with death during pneumonia-associated hospitalization among adults-New York City, 2010-2014.

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BackgroundIn New York City (NYC), pneumonia is a leading cause of death and most pneumonia deaths occur in hospitals.Whether the pneumonia death rate in NYC reflects reporting artifact or is associated with factors during pneumonia-associated hospitalization (PAH) is unknown.We aimed to identify hospital-level factors associated with higher than expected in-hospital pneumonia death rates among adults in NYC.MethodsData from January 1, 2010-December 31, 2014 were obtained from the New York Statewide Planning and sukin body lotion woolworths Research Cooperative System and the American Hospital Association Database.

In-hospital pneumonia standardized mortality ratio (SMR) was calculated for each hospital as observed PAH death rate divided by expected PAH death rate.To determine hospital-level factors associated with higher in-hospital pneumonia SMR, we fit a hospital-level multivariable negative binomial regression model.ResultsOf 148,172 PAH among adult NYC residents in 39 hospitals during 2010-2014, 20,820 (14.06%) resulted dudley thunder hycon 52 300 in in-hospital death.

In-hospital pneumonia SMRs varied across NYC hospitals (0.77-1.23) after controlling for patient-level factors.An increase in average daily occupancy and membership in the Council of Teaching Hospitals were associated with increased in-hospital pneumonia SMR.

ConclusionsDifferences in in-hospital pneumonia SMRs between hospitals might reflect differences in disease severity, quality of care, or coding practices.More research is needed to understand the association between average daily occupancy and in-hospital pneumonia SMR.Additional pneumonia-specific training at teaching hospitals can be considered to address higher in-hospital pneumonia SMR in teaching hospitals.