Document Detail

Are PRO discharge screens associated with postdischarge adverse outcomes?
MedLine Citation:
PMID:  7649753     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We evaluate whether patient outcomes may be affected by possible errors in care at discharge as assessed by Peer Review Organizations (PROs). DATA SOURCES/STUDY SETTING: The three data sources for the study were (1) the generic screen results of a 3 percent random sample of Medicare beneficiaries age 65 years or older who were admitted to California hospitals between 1 July 1987 and 30 June 1988 (n = 20,136 patients); (2) the 1987 and 1988 California Medicare Provided Analysis and Review (MEDPAR) data files; and (3) the American Hospital Association (AHA) 1988 Annual Survey of Hospitals. STUDY DESIGN: Multivariate logistic regression analysis was used to evaluate the association between the results of generic discharge administered by the PROs and two patient outcomes: mortality and readmission within 30 days. The analysis was adjusted for other patient characteristics recorded on the uniform discharge abstract. PRINCIPAL FINDINGS: Four discharge screens indicated an increased risk of an adverse outcome-absence of documentation of discharge planning, elevated temperature, abnormal pulse, and unaddressed abnormal test results at discharge. The other three discharge screens examined-abnormal blood pressure, IV fluids or drugs, and wound drainage before discharge-were unrelated to postdischarge adverse outcomes. CONCLUSIONS: Generic discharge screens based on inadequate discharge planning, abnormal pulse, increased temperature, or unaddressed abnormal tests may be important indicators of substandard care. Other discharge screens apparently do not detect errors in care associated with major consequences for patients.
F Wei; D Mark; A Hartz; C Campbell
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Health services research     Volume:  30     ISSN:  0017-9124     ISO Abbreviation:  Health Serv Res     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-09-27     Completed Date:  1995-09-27     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0053006     Medline TA:  Health Serv Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  489-506     Citation Subset:  IM    
Department of Community Health, School of Public Health, St. Louis University, MO 63108, USA.
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MeSH Terms
Aged, 80 and over
Chi-Square Distribution
Logistic Models
Medicare / statistics & numerical data
Outcome Assessment (Health Care) / statistics & numerical data*
Patient Admission / statistics & numerical data
Patient Discharge* / statistics & numerical data
Patient Readmission / statistics & numerical data
Professional Review Organizations* / statistics & numerical data
Quality of Health Care / statistics & numerical data
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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