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CHF Patients May Fare Better, Pay More at High-Volume Hospitals

Cheryl Clark, for HealthLeaders Media, January 21, 2011

"Understanding which practices employed by high-volume institutions account for these advantages can help improve quality of care and clinical outcomes for all patients with CHF," they wrote.

The researchers used Medicare claims data from 2006 and 2007 to evaluate Hospital Quality Alliance process measures for CHF, 30-day risk-adjusted mortality rates, 30-day risk-adjusted readmission rates and costs per discharge.

Why might hospitals with more experience have better outcomes in CHF patients? 

The authors speculated that hospitals with more patients "might have more incentive to retain familiarity with professional society care guidelines or invest in systems to monitor for adherence to quality metrics."

Or, they might also be more likely to do a better job with patient education, or involve discharge planners.

"In addition, nurses at high-volume centers might be more familiar with CHF-specific patient are and education needs, although we have no data regarding this."

The authors also speculated that higher quality care may provoke higher volume, but they discounted that theory.

"Previous studies have found that patients rarely use publicly available quality data to select a hospital or clinician, and that publishing provider performance has little effect on that provider's market share," they wrote.

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