Quality Measures, DNR Orders, and Inpatient Mortality

January 13, 2016 | Strategic Insights for Health System


Hospital quality metrics may fail to account for patients' do-not-resuscitate (DNR) orders, unfairly penalizing facilities for patients who do not wish to receive certain life-sustaining treatments, according to a study in the January 2016 JAMA Internal Medicine. The authors reviewed the records of more than 90,000 patients admitted with pneumonia to 303 California hospitals during 2011, including data based on the hospitals' rates of DNR orders. They found that DNR rates varied considerably, and that hospitals with higher rates of DNR orders among their patients also reported higher rates of inpatient mortality.

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