Evolving Healthcare Quality in Top Tertiary General Hospitals in China during the China Healthcare Reform (2010–2012) from the Perspective of Inpatient Mortality

• DOI: 10.1371/journal.pone.0140568
• Publication Date: 2015-12-01T19:15:45Z
• Authors: Xie-Min Ma; Xiao-Hong Chen; Ji-Shan Wang; Gary H. Lyman; Zhi Qu; Wen Ma; Jing-Chen Song; Chuan-Kun Zhou; Lue Ping Zhao
• Keywords: Healthcare system; Proxy (statistics)

Healthcare reforms (HR) initiated by many countries impacts on healthcare systems worldwide. Being one of fast developing countries, China launched HR in 2009. Better understanding its impact is helpful for and others further pursuit HR. Here we evaluate inpatient mortality, a proxy to quality, 43 top tertiary hospitals during this critical period. This hospital-based observational study with 8 million discharge summary reports (DSR) from Chinese 2010–2012. Using DSRs, extract the vita status as outcome, addition age, gender, diagnostic codes, surgical codes. Nearly all have expanded their hospitalization capacities As year 2010, mortality (IM) across varies widely 2‰ 20‰. Comparing IM 2011 2012 overall has been substantially reduced (OR = 0.883 0.766, p-values<0.001), showing steady improvements quality. Surgical correlates (correlation 0.60, p-value <0.001), but less uniform. Over these years, also steadily 0.890 0.793, p-values<0.001). Further analyses treatments five major diseases six surgeries revealed that myocardial infarction, cerebral hemorrhage infarction significant improvement. Observed temporal spatial variations demonstrate there substantial disparity quality hospitals, are rapidly improving Evidence-based assessment shed light reform impact. Lessons learnt here relevant refining