Abstract
Abstract 11781: Association of Rapid Response Teams With Hospital Mortality in Medicare Patients
Circulation (New York, N.Y.), Vol.144(Suppl_2), p.A11781
11/16/2021
DOI: 10.1161/circ.144.suppl_2.11781
Abstract
Background:
Rapid response teams (RRT) have been promoted as a strategy to reduce unexpected hospital deaths, as they are designed to evaluate and treat patients experiencing sudden decline. However, evidence to support their effectiveness in reducing in-hospital mortality remains uncertain.
Methods:
Using data from 56 hospitals participating in Get With The Guidelines Resuscitation linked to Medicare, we calculated annual rates of case-mix adjusted mortality for each hospital during 2000-2014. We constructed a hierarchical interrupted time series model to determine whether implementation of a RRT was associated with a reduction in mortality that was larger than expected based on pre-implementation trends alone.
Results:
Over the study period, the median annual number of Medicare admissions across study hospitals was 5214 (range: 408-18,398). The median duration of the pre-implementation period was 7.6 years comprising ~2.5 million admissions, and the median duration of the post-implementation period was 7.2 years comprising ~2.6 million admissions. Before implementation of RRTs, hospital mortality was already decreasing by 2.7% annually (Figure). Implementation of RRTs was not associated with change in mortality in the initial year of implementation (RR for model intercept: 0.98; 95% CI 0.94-1.02;
P=
0.30) or in the mortality trend over time (RR for model slope: 1.01 per-year; 95% CI 0.99-1.02;
P
=0.30). Within individual hospitals, a RRT was associated with a significantly lower than expected mortality at 4 (7.1%) of hospitals, and significantly higher than expected mortality at 2 (3.6%), when compared to pre-implementation trends.
Conclusion:
Among a diverse sample of U.S. hospitals, we found that the implementation of a RRT was not associated with a significant reduction in hospital mortality. Given their prevalence in most U.S. hospitals, further studies are needed to understand best practices in composition, design, and implementation of RRTs.
Details
- Title: Subtitle
- Abstract 11781: Association of Rapid Response Teams With Hospital Mortality in Medicare Patients
- Creators
- Saket Girotra - University of IowaPhilip Jones - Saint Luke's HospitalMary A Peberdy - Virginia Commonwealth UniversityMary S Vaughan Sarrazin - University of IowaPaul S Chan - MID AMERICA HEART INSTITUTE, Kansas City, MO
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.144(Suppl_2), p.A11781
- DOI
- 10.1161/circ.144.suppl_2.11781
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/16/2021
- Academic Unit
- Cardiovascular Medicine; General Internal Medicine; Internal Medicine; Health Management and Policy
- Record Identifier
- 9984363277402771
Metrics
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