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International Journal for Quality in Health Care Advance Access originally published online on February 4, 2009
International Journal for Quality in Health Care 2009 21(2):112-118; doi:10.1093/intqhc/mzp003
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© The Author 2009. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved

Comparison of US accredited and non-accredited rural critical access hospitals

M. Nawal Lutfiyya, Amrita Sikka, Sona Mehta and Martin S. Lipsky

Department of Family and Community Medicine, University of Illinois – Chicago, College of Medicine at Rockford, Rockford, IL 61107, USA

Background. US critical access hospitals play an integral role in rural healthcare. Accreditation may be helpful in assuring that these hospitals provide high-quality care.

Objective. To determine whether quality measures used in the US Centers for Medicare and Medicaid Services Hospital Compare database differed for critical access hospitals based on Joint Commission on Accreditation of Healthcare Organizations accreditation status.

Research design. Cross-sectional with t-test statistics computed on weighted data to ascertain statistically significant differences (P ≤ 0.01).

Main outcome measure. Differences between accredited and non-accredited rural critical access hospitals on quality care indicators related to acute myocardial infarction, heart failure, pneumonia and surgical infection.

Subjects. US critical access hospitals.

Results. The differences between accredited and non-accredited rural critical access hospitals for 4 out of 16 hospital quality indicators were statistically significant (P ≤ 0.01) and favored accredited hospitals. Also, accredited hospitals were more likely to rank in the top half of hospitals for 6 of the 16 quality measures.

Conclusions. The results indicate that in the setting of critical access hospitals, external accreditation appears to result in modestly better performance.

Keywords: hospital accreditation and quality care, quality indicators, critical access hospitals, US rural hospital care, disparities in hospital care

Address reprint requests to: M. Nawal Lutfiyya, Department of Family and Community Medicine, University of Illinois – Chicago, College of Medicine at Rockford, Rockford, IL 61107, USA. Tel: +1-815-395-5783; Fax: +1-815-395-5585; E-mail: lutfiyya{at}uic.edu

Accepted for publication January 13, 2009.


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