1. This exercise builds on the topic of the Hospital Quality Alliance, introduced in the Chapter 8 exercise. The study results are shown again below.

Analysis of data from the [Hospital Quality Alliance] national reporting system shows that performance varies among hospitals and across indicators…. [P]erformance scores for acute myocardial infarction closely predicted performance scores for congestive health failure but not for pneumonia…. [O]ur findings indicate that quality measures had only moderate predictive ability across the three conditions. Although a high quality of care for acute myocardial infarction predicted a high quality of care for congestive heart failure, the former was only marginally better than chance for identifying a high quality of care for pneumonia.

These data do not provide support for the notion that ‘good’

hospitals are easy to identify or consistent in their performance across conditions (Jha et al. 2005, 265, 272).