The Impact of Hospital Quality-Related Practices on Health Outcomes

In this paper we analyze the cross-sectional relationship between hospital quality scores calculated by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and risk-adjusted indicators of outcomes and quality--mortality, rates of surgical/medical misadventures, adverse drug reactions, and length of stay--calculated from Nationwide Inpatient Sample discharge records. The results suggest that greater adherence to JCAHO accreditation standards is not associated with reduced mortality or lower probabiity of avoidable hospital or physician-caused adverse outcomes. Other hospital characteristics, such as teaching/non-teaching and urban/rural status, also exhibit little or no correlation with risk-adjusted survival and adverse-event probabilities.