Tuberc Respir Dis.  2009 Apr;66(4):300-308.

Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia

• Moon S
• Lee JS
• Kim Y
• You SJ
• Choi YK
• Suh SK
• Kim YI

Abstract

BACKGROUND
The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care.
METHODS
The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators.
RESULTS
Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators.
CONCLUSION
It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

Keyword

Pneumonia; Health care quality indicators; Process assessment; Logistic models

MeSH Terms

Anti-Bacterial Agents
Emergencies
Humans
Logistic Models
Oxygen
Pneumonia
Process Assessment (Health Care)
Anti-Bacterial Agents
Oxygen

Figure

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  Figure 1 Medians and variation of process indicators among hospitals. Data are presented as box-and-whisker plot. The horizontal line represents the median, and upper and lower margins illustrate first and third quartile each. Upper and lower end of the vertical line means maximun and minimum value except outliers which are marked with bullet.

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