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Patients hospitalized with community acquired pneumonia (CAP) have a substantial risk of death, but there is evidence that adherence to certain processes of care, including antibiotic administration within 8 hours, can decrease this risk.
Large variability in clinical practice, in addition to the increasing awareness that certain processes of care are associated with improved medical outcome, has led to the development of clinical practice guidelines.
First, the quality score of the Hospital Compare dataset is more an indication of hospital performance on certain processes of care (e.g., for standards and compliance) rather than a measure of treatment outcome (e.g., mortality rate), and the relationship between these two measures is still an ongoing research topic (e.g., [ 64]).
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** Lowest (minimal) percentage of patients having received at least a certain number of processes of care where "don't know" and missing data are assumed as "not having received the process of care".
***Highest (maximal) percentage of patients having received at least a certain number of processes of care where "don't know" and missing data are assumed as "having received the process of care".
The second possibility is that the clusters themselves exert some influence on outcome (e.g. patients within a certain hospital may be more likely to have a positive outcome due to different processes of care or quality of hospital staff).
Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly.
Figure 1 Processes of care associated with lowest practice variation.
This is "delivery system reform" - changing the processes of care.
We must track and improve the processes of care.
Process: processes of care score per practice, see Table 1.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com