BACKGROUND AND PURPOSE: 

• Lam et al. (BMJ, 2018) assessed whether patients admitted to accredited hospitals (Joint Commission) had superior outcomes when compared to independent accrediting organizations  

METHODS: 

• Observational study  
  • Hospitals in the United States 
  • Patients ≥65 years of age  
• Hospitals were either 
  • Accredited by the Joint Commission 
  • Reviewed by state survey or accredited by an alternative organization  
• Main outcomes  
  • Death at 30 days from the admission date (risk adjusted) 
  • Readmission rates at 30 days  
  • Based on 15 common medical causes of hospital admissions and six common costly surgical procedures 
• Healthcare Provider and Systems (HCAHPS) patient experience scores also assessed  
• P value set at 0.0125 as threshold for significance

RESULTS: 

• 4,242,648 patients 
  • 3337 accredited hospitals | 1063 state-reviewed hospitals 
• Compared to patients at state-based reviewed hospitals, patients admitted to accredited hospitals had 
  • Lower 30 day mortality rates than those at hospitals that were reviewed by a state survey agency (did not meet the prespecified P level)  
    • 10.2% vs 10.6%, difference 0.4% (95% CI, 0.1% to 0.8%), P=0.03) 
  • Identical rates of mortality for the six surgical conditions 
    • 2.4% vs 2.4%, difference 0.0% (95% CI, −0.3% to 0.3%; P=0.99) 
  • Lower readmission rates for 15 medical conditionals  
    • 22.4% vs 23.2%, difference 0.8% (95% CI, 0.4% to 1.3%), P<0.001)  
  • No difference was seen for surgical conditions 
    • 15.9% vs 15.6%, difference 0.3% (95% CI, −1.2% to 1.6%; P=0.75) 
• There were no statistically significant differences in 30 day mortality or readmission rates (for both the medical or surgical conditions) between hospitals accredited by The Joint Commission and those accredited by other independent organizations 
• Patient experience scores were modestly better at state survey hospitals than at accredited hospitals 
  • Summary star rating 3.4 vs 3.2, difference 0.2 (95% CI, 0.1 to 0.3; P<0.001)

CONCLUSION: 

• US hospital accreditation done by independent organizations rather than Joint Commission is not associated with lower mortality
• The authors conclude 

In the present study, we found that hospitals accredited by private organizations did not have better patient outcomes than hospitals reviewed by a state survey agency. Furthermore, we found that accreditation by The Joint Commission, which is the most common form of hospital accreditation, was not associated with better patient outcomes than other lesser known, independent accrediting agencies.

Learn More – Primary Sources: 

Association between patient outcomes and accreditation in US hospitals: observational study

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