Pediatric Quality Indicators

When compared to the state average rates, 10 hospitals (3.8 percent) are rated “Above Average,” and 12 hospitals (4.6 percent) are rated “Below Average” on at least one risk-adjusted Pediatric Quality Indicator (PDI).

Which PDIs Are Included in This Analysis?

The 2021 report consists of five PDIs:

  • Neonatal Blood Stream Infection
  • Accidental Puncture or Laceration
  • Postoperative Respiratory Failure
  • Postoperative Sepsis
  • Central Venous Catheter-Related Blood Stream Infection

Why Are the PDIs Important?

The PDIs are calculated for pediatric patients who develop certain complications in the hospital before discharge. The PDI rates vary substantially across hospitals, suggesting differential quality of care provided. The hospitals can utilize these findings to improve their quality of pediatric care and consumers can use them to make informed health care decisions.

Which Hospitals Have Above Average and Below Average Ratings?

Hospitals are rated “Above Average,” “Below Average,” or “Average” by comparing their risk-adjusted rates with the overall state rates for each PDI. Risk adjustment is a statistical methodology that takes into account a patient’s age, sex, underlying health conditions and surgeries the patient has undergone. The majority of hospitals are rated “Average,” indicating their PDI rates are not significantly different than the state average. Hospitals with higher PDI rates are distinguished from those with lower rates, indicating opportunities for care quality improvement.

Key Findings

  • A total of 555,327 patient records from 261 hospitals are included in the analysis.
  • When compared to the state average rates, 10 hospitals (3.8 percent) are rated “Above Average,” and 12 hospitals (4.6 percent) are rated “Below Average” on at least one risk-adjusted PDI.
  • There are 242 (92.7 percent) hospitals rated as “Average,” or not significantly different from the state average, for all five indicators.
  • In general, hospitals show fairly consistent performance across all five indicators. Three hospitals (1.1 percent), however, have “mixed” results – they are rated “Above Average” on at least one indicator and “Below Average” on at least one indicator.
  • The California statewide rate for postoperative respiratory failure is 4.4 percent, much higher than the national rate of 2.6 percent. Three California hospitals account for more than 80 percent of the state’s cases on this measure, indicating that the California results are largely influenced by these hospitals.

Note: This visualization shows hospitals’ PDI rates and ratings in 2021. The rating filter allows the user to select a performance category (“Above Average,” “Below Average,” or “Average”) to view the hospitals in that category. Any blank spaces indicate that fewer than three cases were reported.

Where are Hospitals with Above Average and Below Average Ratings Located?

Note: This visualization shows a map displaying geographic locations of hospitals with “Above Average,” “Below Average,” and “Average” performance ratings on each of the five PDIs in 2021. Any hospitals not listed per condition indicate that fewer than three cases were reported.

How HCAI Created This Product

The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators are standardized, evidence-based measures designed to assess health care quality. Utilizing readily available hospital inpatient administrative data, these indicators assess, monitor, and track clinical performance and outcomes, highlighting potential areas for quality improvement and further study. Specifically, the Pediatric Quality Indicators (PDIs) focus on preventable complications and hospitalizations in pediatric care. Analyzing patient records from hospitals across California and concentrating on five PDIs, the implementation of these indicators incorporates a risk adjustment method. This adjusts for patient demographic and health condition variations, allowing for equitable comparisons across hospitals.

HCAI uses diverse data sources to generate state/county-level and individual hospital outcome (quality) reports. These data include hospital-submitted information on patient care (e.g. diagnoses, procedures), billing charges, expected payer, and individual patient demographics (e.g. age, sex, race). To protect patient personal information, the California Health and Human Services Agency has adopted a policy of statistically masking or de-identifying sensitive data (CalHHS Data De-identification guidelines).

Additional Information

Topic: Healthcare Quality
Source Link: Healthcare Quality – AHRQ Quality Indicators
Citation: HCAI – AHRQ Quality Indicators – Pediatric Quality Indicators for California Hospitals, 2021
Temporal Coverage: 2021
Spatial/Geographic Coverage: Statewide, County
Frequency: Annually