Quality of Care for the Treatment of Acute Medical Conditions in US Hospitals

0.85 (0.81-0.95), 0.64 (0.52-0.78), and 0.88 (0.800.97) for acute myocardial infarction, congestive heart failure, and pneumonia, respectively. After adjustment, for-profit hospitals consistently underperformed notfor-profit hospitals for each condition, with odds ratios (ORs) ranging from 0.79 (95% confidence interval [CI], 0.78-0.80)forthecongestiveheartfailurecompositemeasureto0.90(95%CI,0.89-0.91)forthepneumoniacomposite. Major teaching hospitals had better performance onthetreatmentanddiagnosiscomposite(OR,1.37;95% CI, 1.34-1.39) but worse performance on the counseling and prevention composite (OR, 0.83; 95% CI, 0.820.84). Hospitals with more technology available, higher registered nurse staffing, and federal/military designation had higher performance. Conclusions: Patients are more likely to receive highquality care in not-for-profit hospitals and in hospitals with high registered nurse staffing ratios and more investment in technology. Because payments and sources of payments affect some of these factors (eg, investments in technology and staffing ratios), policy makers should evaluate the effect of alternative payment approaches on quality. Arch Intern Med. 2006;166:2511-2517