JAMA article shows patient safety measures surpass pre-pandemic levels – American Hospital Association

Report on U.S. Hospital Performance Improvements and Alignment with Sustainable Development Goals

Core Research Findings on Patient Outcomes

A study published in JAMA, involving 715 U.S. hospitals between 2019 and 2024, documents significant advancements in patient care and safety. The core findings indicate a positive trajectory in healthcare delivery, even amidst challenges such as increased patient acuity.

• Mortality Reduction: Risk-adjusted in-hospital mortality rates declined significantly following the COVID-19 pandemic, resuming a pre-pandemic trend of continuous improvement.
• Elevated Patient Acuity: Despite the reduction in mortality, patient acuity, as measured by the Case Mix Index (CMI), has established a new, elevated baseline post-pandemic, indicating that hospitals are successfully managing more complex patient cases.
• Resumption of Improvement Trends: The data suggests that while patient acuity remains high, hospital mortality outcomes have successfully returned to prior improvement trajectories.

Contribution to Sustainable Development Goal 3 (Good Health and Well-being)

The documented improvements in U.S. hospital performance directly support the achievement of the United Nations Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being for all at all ages. The findings align with several key targets within this goal.

1. Target 3.4 (Reduce Premature Mortality): The significant decline in in-hospital mortality is a direct contribution to reducing premature deaths from non-communicable diseases through effective treatment, a primary objective of SDG Target 3.4.
2. Target 3.8 (Achieve Universal Health Coverage): Enhancing patient safety and achieving better outcomes for sicker patients are fundamental to providing high-quality essential healthcare services. This progress strengthens the foundation for universal health coverage, as outlined in SDG Target 3.8.
3. Target 3.d (Strengthen Health System Capacity): The ability of health systems to improve performance despite increased patient complexity demonstrates strengthened capacity for risk reduction and management of national health challenges, which is central to SDG Target 3.d.

Supporting Analyses on Healthcare Quality

Further evidence from reports by the American Hospital Association (AHA) and Vizient corroborates these findings, highlighting a broad-based enhancement of healthcare quality and safety.

• September 2024 Report: This analysis confirmed that hospitals’ performance on key patient safety and quality measures has improved, surpassing pre-pandemic levels.
• August 2025 Report: A subsequent report connected these systemic improvements to tangible benefits, showing demonstrably better outcomes for hospitalized surgical patients.

SDGs Addressed in the Article

SDG 3: Good Health and Well-being

• The article’s central theme is the improvement of health outcomes within US hospitals. It directly addresses SDG 3 by focusing on patient safety, quality of care, and mortality rates. The discussion of a significant decline in “risk-adjusted in-hospital mortality” and “better outcomes for hospitalized surgical patients” is a clear reflection of progress towards ensuring healthy lives and promoting well-being.

Specific SDG Targets Identified

Target 3.4: Reduce premature mortality from non-communicable diseases

• This target aims to reduce premature death through prevention and treatment. The article supports this by highlighting that “risk-adjusted in-hospital mortality declined significantly,” which indicates that treatment within hospitals is becoming more effective, thereby reducing premature deaths that occur during hospitalization.

Target 3.8: Achieve universal health coverage and access to quality health-care services

• This target includes ensuring access to quality essential health-care services. The article’s reference to a report “highlighting hospitals’ efforts that have improved performance on key patient safety and quality measures” directly relates to enhancing the quality of health services provided to patients.

Target 3.d: Strengthen capacity for management of health risks

• This target focuses on strengthening the capacity to manage health risks, particularly after a crisis. The article states that improvements in mortality occurred “following the COVID-19 pandemic” while “patient acuity as measured by CMI remained elevated.” This suggests that hospitals have strengthened their capacity to manage the health risks associated with caring for sicker patients in a post-pandemic environment.

Indicators for Measuring Progress

Explicit Indicators

• Risk-adjusted in-hospital mortality: The article explicitly states that this metric “declined significantly.” It serves as a direct, quantifiable indicator for measuring progress in reducing premature deaths (Target 3.4) and assessing the quality of care (Target 3.8).
• Patient acuity as measured by CMI (Case Mix Index): This is mentioned as a specific measure used in the study to assess how sick patients were. While not an outcome itself, it is a critical indicator used to risk-adjust the mortality data, providing context for the improvements in care (Target 3.d).

Implied Indicators

• Performance on key patient safety and quality measures: The article refers to a report on these measures. Although the specific metrics are not listed, this phrase implies a set of indicators used to track and evaluate the quality and safety of health services (Target 3.8).
• Outcomes for hospitalized surgical patients: The mention of a report showing “better outcomes for hospitalized surgical patients” implies the use of specific indicators to measure surgical success rates, complication rates, and recovery times, which contribute to overall mortality reduction and quality of care (Targets 3.4 and 3.8).

Table of SDGs, Targets, and Indicators

Source: aha.org