Measure for Measure: Analyzing California Hospital Characteristics and Performance
Bruce Spurlock, M.D., Convergence Health
December 2008
If specific hospital characteristics lead to higher or lower clinical performance, that information would be useful to institutions in improving their own performance. Research conducted in 2008 using California Hospital Assessment and Reporting Taskforce (CHART) data and information from the California Office of Statewide Health Planning and Development (OSHPD) found little connection between 30 hospital characteristics and clinical performance. The following variables were examined:
- Teaching status;
- Ownership;
- Region;
- Net income;
- Gross revenue;
- Operating margin;
- System size; and
- Disproportionate Share Hospital (DSH) status.
DSH status was one of only four characteristics linked with performance. DSH hospitals, which treat a significant proportion of indigent and Medi-Cal patients, did more poorly on four measures of clinical performance: CABG mortality, ICU mortality, patient experience, and improvement in heart failure care.
Overall, however, the research indicated that all hospitals, regardless of type, could become high performers by implementing effective practices. The findings also suggested that researchers, policymakers, and others should discontinue the practice of separating hospitals by characteristics or type when attempting to assess or improve performance.
An issue brief summarizes the high points of the study, and a report describes the research and findings in detail. Both are available under Document Downloads below.