Date of Conferral

2019

Degree

Doctor of Healthcare Administration, DHA

School

Health Services

Advisor

James Rohrer

Abstract

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day mortality rates for pneumonia, chronic heart failure, and acute myocardial infarction data, while also adjusting for selected organizational descriptors: state of residency, Medicare expansion, safety-net status, ownership type, teaching classification, and number of licensed beds. Linear regression demonstrated that Leapfrog grades are not reliable predictors of the 3 inpatient mortality rates analyzed. The study demonstrated that ownership type was a significant predictor for 2 of the 3 dependent variables. Furthermore, most of the covariates also provided some predictive value for at least 1 of the included outcomes; however, in most cases, the effect (β) was small. This study can help provide positive social change by elucidating that Leapfrog grades are not reliable predictors of patient outcomes for consumers, while also demonstrating that efforts to reduce 30-day mortality rates, especially for pneumonia, can be targeted by selected states, ownership type, and teaching status.

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