BACKGROUND: It is unknown how in-hospital @entity1167 (IHCA) rates vary across hospitals and predictors of variability. OBJECTIVES: Measure variability in IHCA across hospitals and determine if hospital-level factors predict differences in case-mix adjusted event rates. RESEARCH DESIGN: Get with the Guidelines Resuscitation (GWTG-R) (n=433 hospitals) was used to identify IHCA events between 2003 and 2007. The American Hospital Association survey, Medicare, and US Census were used to obtain detailed information about GWTG-R hospitals. @entity1 : Adult @entity1 with IHCA. MEASURES: Case-mix-adjusted predicted IHCA rates were calculated for each hospital and variability across hospitals was compared. A regression model was used to predict case-mix adjusted event rates using hospital measures of volume, nurse-to-bed ratio, percent intensive care unit beds, palliative care services, urban designation, volume of black @entity1 , income, @entity130 designation, academic designation, cardiac surgery capability, and a @entity1 risk score. RESULTS: We evaluated 103,117 adult IHCAs at 433 US hospitals. The case-mix adjusted IHCA event rate was highly variable across hospitals, median 1/1000 bed days (interquartile range: 0.7 to 1.3 events/1000 bed days). In a multivariable regression model, case-mix adjusted IHCA event rates were highest in urban hospitals [rate ratio (RR), 1.1; 95% confidence interval (CI), 1.0-1.3; P=0.03] and hospitals with higher proportions of black @entity1 (RR, 1.2; 95% CI, 1.0-1.3; P=0.01) and lower in larger hospitals (RR, 0.54; 95% CI, 0.45-0.66; P<0.0001). CONCLUSIONS: Case-mix adjusted IHCA event rates varied considerably across hospitals. Several hospital factors associated with higher IHCA event rates were consistent with factors often linked with lower hospital quality of care.

Variability in case-mix adjusted in-hospital XXXX rates.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PARTICIPANTS'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest']
@entity1167 :: (MESH:D006323,Disease) :: ['cardiac arrest']
