Rhode Island Department of Health: Trends in Prevention Indicators for Hospital Care in Rhode Island
The Rhode Island Department of Health contracted with the National Perinatal Information Center/Quality Analytic Services (NPIC/QAS) to provide a trend report that would compare the hospital care provided in the state to national norms and provide background for later reports that would compare Rhode Island hospitals among themselves.
Using the Agency for Healthcare Research and Quality (AHRQ) Patient Safety, Inpatient Quality and Prevention Indicator software and the state discharge abstract data set, NPIC/QAS compared the care provided to inpatients in hospitals in Rhode Island to national data during the six-year period (1999-2004).
Using hospital discharge data is attractive because -
- there were few or no additional data collection costs to the hospitals and the Department,
- the data covers the full range of hospital care, rather than the selected patient populations covered by the clinical measures from medical records, and
- it allowed for comparisons to national data and to state-level data in other states where similar data are collected.
All the indicators profiled in the report were developed by the Healthcare Cost and Utilization Project (HCUP) of the federal Agency for Healthcare Research and Quality (AHRQ). Included were 27 inpatient quality indicators (IQI), 29 patient safety indicators (PSI) and 14 prevention quality indicators (PQI).
The PSIs and IQIs measure the quality of inpatient hospital care. The profiled indictors were selected because they affect large numbers of patients in hospitals and because they focus attention on complications of care that may be improved by hospital action.
The PQIs are designed to “flag potential problems resulting from a breakdown of health care services by tracking hospitalizations for conditions that should be treatable on an outpatient basis, or that could be less severe if treated early and appropriately. The PQIs represent the current state of the art in measuring the outcomes of preventive and outpatient care through analysis of inpatient discharge data” (Agency for Healthcare Research and Quality, Prevention Quality Indicator Guide, Version 3.0a, February 20, 2006).Although more work is needed before these data can be used to compare individual hospitals, the report showed how the overall quality of hospital care in Rhode Island compared to the quality of care nationally. As quality indicators based on hospital discharge data improve, and as the underlying data are validated, this data source will provide additional measures of health care quality in the state's hospitals.