In-hospital death of critically ill patients who have congestive heart failure: does size of hospital matter?

Abstract

Data from the British Columbia Linked Health Database were analyzed to determine if size of hospital is associated with in-hospital death of critically ill adults whose admitting diagnosis is congestive heart failure (CHF). Patients who were <19 years of age, transferred from or to other hospitals, or who developed CHF as a complication were excluded. In unadjusted logistic regression analysis of 2616 patients, the odds ratio (OR) for in-hospital death associated with a doubling of the number of hospital beds was 1.12 (95% confidence interval [CI] = 1.03-1.23; P = .01). After adjustment for age, sex, CHF-specific comorbidity index, number of cardiac and noncardiac procedures, number of hospital admissions for CHF in the preceding year, and socioeconomic variables, the OR was 1.08 (95% CI = 0.96-1.20; P = .21). The conclusion is that the adjusted rate of in-hospital deaths for this patient group does not differ significantly based solely on the number of acute hospital beds.