Compliance with hospital accreditation and patient mortality: a Danish nationwide population-based study

Objective To examine the association between compliance with hospital accreditation and 30-day mortality. Design A nationwide population-based, follow-up study with data from national, public registries. Setting Public, non-psychiatric Danish hospitals. Participants In-patients diagnosed with one of the 80 primary diagnoses. Intervention Accreditation by the first version of The Danish Healthcare Quality Programme for hospitals from 2010 to 2012. Compliance were assessed by surveyors on an on-site survey and awarded the hospital as a whole; fully ( n = 11) or partially accredited ( n = 20). A follow-up activity was requested for partially accredited hospitals; submitting additional documentation ( n = 11) or by having a return-visit ( n = 9). Main Outcome Measure(s) All-cause mortality within 30-days after admission. Multivariable logistic regression was used to compute odds ratios (ORs) for 30-day mortality adjusted for six confounding factors and for cluster effect at hospital level. Results A total of 276 980 in-patients were identified. Thirty-day mortality risk for in-patients at fully ( n = 76 518) and partially accredited hospitals ( n = 200 462) was 4.14% (95% confidence interval (CI):4.00–4.28) and 4.28% (95% CI: 4.20–4.37), respectively. In-patients at fully accredited hospitals had a lower risk of dying within 30-days after admission than in-patients at partially accredited hospitals (adjusted OR of 0.83; 95% CI: 0.72–0.96). A lower risk of 30-day mortality was observed among in-patients at partially accredited hospitals required to submit additional documentation compared with in-patients at partially accredited hospitals requiring a return-visit (adjusted OR 0.83; 95% CI: 0.67–1.02). Conclusion Admissions at fully accredited hospitals were associated with a lower 30-day mortality risk than admissions at partially accredited hospitals.