Can Performance Monitoring Identify Any Effect of Hospital for Improvement/Worsening: Case of Heart Failure Patients

This study offers original insights to further the ongoing debate about the stability of ‘hospital effect’ on performance with administrative data as a source of evidence. The overall assumption behind is investigating the debate on organizing the hospitals by learning from their previous performance to transform change. In this way, one available evidence is the administrative data that are collected in healthcare systems to document their activity and have had an administrative rational behind. Using statistical tests (multi-level hierarchical logistic models) on the variation of performance of the hospital, we used 78,907 records for Adult Heart Failure (HF) patients from 117 hospitals in Lombardy Region considering only Incident cases from 2010 to 2012 to answer to our research questions. what we observed was that mortality and readmission were explained by a few different hospital characteristics like the percentage of surgical DRG and type of hospital in mortality model and mean length of stay in readmission one. One explanation could be the case of connection between hospital managers’ capabilities to implement short-term improvement.