Non-accredited Hospitals Research Articles

Baby-Friendly Hospitals, Social Determinants of Health, and Disparities in Breastfeeding Initiation in a Low-Income Population, 2017-2020.

Organizational-level interventions (i.e., Baby-Friendly Hospital Initiative) that support breastfeeding and target breastfeeding initiation are critical to reducing breastfeeding disparities and promoting breastfeeding equity. To determine the association between delivery in a Baby-Friendly accredited hospital and breastfeeding initiation among United States recipients of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Washington DC, the majority of whom report their race as Black. We conducted a secondary analysis of de-identified program data collected as part of routine WIC visits from the Washington DC WIC program, 2017-2020. Women who delivered a firstborn, singleton infant were included (N = 8,225). Multivariable logistic regression models accounted for social determinants of health and other factors. One set of models included a binary exposure variable (Baby-Friendly accredited vs. non-accredited hospitals), and another set included a categorical exposure variable for hospitals (1) Baby-Friendly accredited, (2) Baby-Friendly activities but not accredited, and (3) neither Baby-Friendly activities nor accredited. Breastfeeding initiation was 57.4% (n = 1988) for women delivering in accredited hospitals versus 55.4% (n = 2540) in non-accredited hospitals and multivariable model results were non-significant (OR = 0.95, 95% CI [0.86, 1.05]). However, more women initiated breastfeeding who delivered in either accredited hospitals (57.4%, n = 1988) or hospitals with Baby-Friendly activities but not accredited (55.9%, n = 2430) compared to those delivering in hospitals with neither (45.3%, n = 110), and multivariable models results concurred (Baby-Friendly accredited hospitals OR = 1.44, 95% CI [1.07, 1.94]; Baby-Friendly activities but not accredited, (OR = 1.55, 95% CI [1.16, 2.09]). Organizational-level interventions that create hospital environments supportive of breastfeeding initiation are important to promote equity in breastfeeding, but underlying social determinants of breastfeeding outcomes must be addressed.

Association of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery.

The National Accreditation Program for Rectal Cancer (NAPRC) defined a set of standards in 2017 centered on multidisciplinary program structure, evidence-based care processes, and internal audit to address widely variable rectal cancer practices and outcomes across US hospitals. There have been no studies to-date testing the association between NAPRC accreditation and rectal cancer outcomes. This was a retrospective, observational study of Medicare beneficiaries aged 65 to 99 years with rectal cancer who underwent proctectomy from 2017 to 2020. The primary exposure was NAPRC accreditation and the primary outcomes included mortality (in-hospital, 30 day, and 1 year) and 30-day complications, readmissions, and reoperations. Associations between NAPRC accreditation and each outcome were tested using multivariable logistic regression with risk-adjustment for patient and hospital characteristics. Among 1,985 hospitals, 65 were NAPRC-accredited (3.3%). Accredited hospitals were more likely to be nonprofit and teaching with 250 or more beds. Among 20,202 patients, 2,078 patients (10%) underwent proctectomy at an accredited hospital. Patients at accredited hospitals were more likely to have an elective procedure with a minimally invasive approach and sphincter preservation. Risk-adjusted in-hospital mortality (1.1% vs 1.3%; p = 0.002), 30-day mortality (2.1% vs 2.9%; p < 0.001), 30-day complication (18.3% vs 19.4%; p = 0.01), and 1-year mortality rates (11% vs 12.1%; p < 0.001) were significantly lower at accredited compared with nonaccredited hospitals. NAPRC-accredited hospitals have lower risk-adjusted morbidity and mortality for major rectal cancer surgery. Although NAPRC standards address variability in practice, without directly addressing surgical safety, our findings suggest that NAPRC-accredited hospitals may provide higher quality surgical care.

Geographic distance to Commission on Cancer-accredited and nonaccredited hospitals in the United States.

The Commission on Cancer (CoC) establishes standards to support multidisciplinary, comprehensive cancer care. CoC-accredited cancer programs diagnose and/or treat 73% of patients in the United States. However, rural patients may experience diminished access to CoC-accredited cancer programs. Our study evaluated distance to hospitals by CoC accreditation status, rurality, and Census Division. All US hospitals were identified from public-use Homeland Infrastructure Foundation-Level Data, then merged with CoC-accreditation data. Rural-Urban Continuum Codes (RUCC) were used to categorize counties as metro (RUCC 1-3), large rural (RUCC 4-6), or small rural (RUCC 7-9). Distance from each county centroid to the nearest CoC and non-CoC hospital was calculated using the Great Circle Distance method in ArcGIS. Of 1,382 CoC-accredited hospitals, 89% were in metro counties. Small rural counties contained a total of 30 CoC and 794 non-CoC hospitals. CoC hospitals were located 4.0, 10.1, and 11.5 times farther away than non-CoC hospitals for residents of metro, large rural, and small rural counties, respectively, while the average distance to non-CoC hospitals was similar across groups (9.4-13.6 miles). Distance to CoC-accredited facilities was greatest west of the Mississippi River, in particular the Mountain Division (99.2 miles). Despite similar proximity to non-CoC hospitals across groups, CoC hospitals are located farther from large and small rural counties than metro counties, suggesting rural patients have diminished access to multidisciplinary, comprehensive cancer care afforded by CoC-accredited hospitals. Addressing distance-based access barriers to high-quality, comprehensive cancer treatment in rural US communities will require a multisectoral approach.

The influence of hospital accreditation on nurses’ perceptions of patient safety culture

ObjectivesHospitals’ accreditation process is carried out to enhance the quality of hospitals’ care and patient safety practices as well. The current study aimed to investigate the influence of hospitals’ accreditation on patient safety culture as perceived by Jordanian hospitals among nurses.MethodsA descriptive cross-sectional correlational survey was used for the current study, where the data were obtained from 395 nurses by convenient sampling technique who were working in 3 accredited hospitals with 254 nurses, and 3 non-accredited hospitals with 141 nurses, with a response rate of 89%.ResultsThe overall patient safety culture was (71.9%). Moreover, the results of the current study revealed that there were no statistically significant differences between the perceptions of nurses in accredited and non-accredited hospitals in terms of perceptions of patient safety culture.ConclusionThe current study will add new knowledge about nurses’ perceptions of patient safety culture in both accredited and non-accredited hospitals in Jordan which in turn will provide valid evidence to healthcare stakeholders if the accreditation status positively affects the nurses’ perceptions of patient safety culture or not. Continuous evaluation of the accreditation application needs to be carried out to improve healthcare services as well as quality and patient safety.

Survey of Nutritional Screening Status as Well as Dietitian to Patient Ratio in Various Healthcare Setups in India

It’s very well documented that malnutrition is an independent risk factor that has an impact on treatment outcomes and further influences the quality of life and survivorship. Nutritional attention with timely intervention is an integral component of patient care which corresponds to improved disease outcomes. Adequate nutrition not only provides economic and physiological benefits but also ensures psychological comfort throughout the patient’s journey and during and after treatment. Evaluation of the patient’s nutritional status is critical in determining the nutritional prescription for the patient. Several studies indicate early identification of malnourished patients or at risk of malnutrition is the key to begin timely and adequate nutrition attention. This multi-centre study attempted a nationwide online survey on malnutrition screening from 19th November to 18th December 2022. Out of 644 responses received, 443 were considered for analysis, and 201 were excluded. Responses from hospitals with less than 50 beds and multiple entries from the same hospital were not considered for analysis. Out of 443 hospitals, 287 (64.7%) were accredited and 156 (35.2%) were non-accredited. It was observed in the survey that nutritional screening (NS) was performed in 361 (81.5%) hospitals out of 443. A majority (90.9%) of the accredited hospitals (n=261) undertook regular NS as opposed to government and charitable trust hospitals (n=100). For NS, 47.4% of accredited and 22.4 % of non-accredited hospitals used a single screening tool of choice. There were 26 non-accredited hospitals with no dietician service. The average number of dieticians in accredited hospitals and non-accredited hospitals were 4.4±3.94 SD and 2.3±3.93 respectively. The dietician-patient ratio in accredited and non-accredited hospitals was 1:73, and 1:212 respectively. Conclusion: Adequate and standard NS practices are lacking in both accredited and non-accredited hospitals with a poor dietitian-to-patient ratio. We propose a better dietician-patient ratio and a simple and rapid first-line tool to detect malnutrition in patients in Indian healthcare setups where there is a massive influx of patients to be matched with multifaceted socio-economic issues and fewer staff. Keywords: Nutrition screening, Malnutrition, Dietitian­Patient ratio, Nutrition care pathway

Health Care Providers' Awareness of Occurrence Variance Reports and Their Magnitude at Accredited Vs. Non-Accredited Hospitals: A Cross-Sectional Comparative Study

Health Care Providers' Awareness of Occurrence Variance Reports and Their Magnitude at Accredited Vs. Non-Accredited Hospitals: A Cross-Sectional Comparative Study

Healthcare Providers' Awareness of Occurrence Variance Reports and Their Magnitude at Accredited Versus Non-Accredited Hospitals: A Cross-Sectional Descriptive Study

Healthcare Providers' Awareness of Occurrence Variance Reports and Their Magnitude at Accredited Versus Non-Accredited Hospitals: A Cross-Sectional Descriptive Study

INNOVATION IN HEALTH CARE SERVICES AND HOSPITAL AMBULATORY ACCREDITATION AS A DETERMINANT OF PERCEPTION OF QUALITY OF CARE: A QUASI-EXPERIMENTAL STUDY FOR COLOMBIA

This study analyzed the perception of compliance with the four factors of innovation in medical services in two groups of patients after undergoing outpatient procedures in an accredited and a non-accredited hospital. Seventy-eight patients were treated at the accredited hospital and 80 at the non-accredited one. A quasi-experimental design based on a pre-test, post-test, and a focus group was applied. A Welch correction t-test and a Tau Kendall correlation coefficient were also applied. Patients treated in the accredited hospital considered that the four characteristics of innovation studied were better applied, and that accreditation in outpatient procedures improves the hospital to achieve its institutional objective. This research will contribute to understanding how innovation in healthcare impacts the perception of quality of observed patients. The present research document is the result of the joint work of the Research Group "Democracy and Modernization of the Colombian State".

Analysis of hospital website contents for promoting medical tourism among accredited and non-Accredited hospitals

Hospital websites act as significant marketing channels for promoting and showing medical destinations, amenities, medical personnel, and services. It is believed that the accreditation status of hospitals assures the provision of quality care and adherence to high standards of patient safety practices. Hence, a cross-sectional analysis of hospital websites is performed to examine the association between the status of accreditation and hospital website content in promoting medical tourism. The contents of 111 hospitals’ websites were coded using an ‘ad-hoc Codebook’ that has five categories of website information summing to a total of 38 items and the total evaluation scores were calculated for each hospital. The findings show a significant difference in the 3 groups of hospitals. JCI accredited hospitals displayed most of the information on their websites significantly, followed by NABH accredited hospitals. Minimum information such as accommodation/travel arrangements and photos of the facilities were predominantly displayed on the websites of non-accredited hospitals. A high percentage of hospitals need improvement in the areas of admission and medical services follow-up through phone calls, email, or real-time chats.

Accreditation and clinical outcomes: shorter length of stay after first-time hospital accreditation in the Faroe Islands.

The aim of accreditation is to improve quality of care and patient safety. However, studies on the effectiveness of accreditation on clinical outcomes are limited and inconsistent. Comparative studies have contrasted accredited with non-accredited hospitals or hospitals without a benchmark, but assessments of clinical outcomes of patients treated at hospitals undergoing accreditation are sparse. The Faroe Islands hospitals were accredited for the first time in 2017, making them an ideal place to study the impact of accreditation. We aimed to investigate the association between first-time hospital accreditation and length of stay (LOS), acute readmission (AR) and 30-day mortality in the unique situation of the Faroe Islands. We conducted a before and after study based on medical record reviews in relation to first-time accreditation. All three Faroese hospitals were voluntarily accredited using a modified second version of the Danish Healthcare Quality Programme encompassing 76 standards. We included inpatients 18 years or older treated at a Faroese hospital with one of six clinical conditions (stroke/transient ischemic attack (TIA), bleeding gastic ulcer, chronic obstructive pulmonary disease (COPD), childbirth, heart failure and hip fracture) in 2012-2013 designated 'before accreditation'or 2017-2018' after accreditation'. The main outcome measures were LOS, all-cause AR and all-cause 30-day mortality. We computed adjusted cause-specific hazard rate (HR) ratios using Cox Proportional Hazard regression with before accreditation as reference. The analyses were controlled for age, sex, cohabitant status, in-hospital rehabilitation, type of admission, diagnosis and cluster effect at patient and hospital levels. The mean LOS was 13.4 days [95% confidence interval (95% CI): 10.8, 15.9] before accreditation and 7.5 days (95% CI: 6.10, 8.89) after accreditation. LOS of patients hospitalized after accreditation was significantly shorter [overall, adjusted HR = 1.23 (95% CI: 1.04, 1.46)]. By medical condition, only women in childbirth had a significantly shorter LOS [adjusted HR = 1.30 (95% CI: 1.04, 1.62)]. In total, 12.3% of inpatients before and 9.5% after accreditation were readmitted acutely within 30 days of discharge, and 30-day mortality was 3.3% among inpatients before and 2.8% after accreditation, respectively. No associations were found overall or by medical condition for AR [overall, adjusted HR = 1.34 (95% CI: 0.82, 2.18)] or 30-day mortality [overall, adjusted HR = 1.33 (95% CI: 0.55, 3.21)]) after adjustment for potential confounding factors. First-time hospital accreditation in the Faroe Islands was associated with a significant reduction in LOS, especially of women in childbirth. Notably, shorter LOS was not followed by increased AR. There was no evidence that first-time accreditation lowered the risk of AR or 30-day mortality.

Stroke thrombectomy volume, rather than stroke center accreditation status of hospitals, is associated with mortality and discharge disposition

BackgroundFew studies have explored the association between stroke thrombectomy (ST) volume and hospital accreditation with clinical outcomes.ObjectiveTo assess the association of ST case volume and accreditation status with in-hospital mortality...

Patients' Evaluation of the Quality of Emergency Care Services in Jordan: Integration of Patient Centeredness Model.

Accreditation is viewed to enhance the total quality of healthcare. The present study aims at assessing patients' perspectives toward the quality of emergency healthcare services at different hospitals with different characteristics in Jordan. The elements of patients' perception were aligned with the conceptual framework of Patient Centeredness Model. This descriptive cross-sectional study was carried out in four emergency departments from different healthcare sectors and accreditation statuses in Jordan. Less urgent/nonurgent, alert, and cooperative patients were identified directly after the completion of emergency treatment. The perspectives of patients about the quality of emergency services were evaluated by 10 domains articulated in a validated accident and emergency questionnaire. A total of 276 patients were enrolled in the study. Private sector scored higher in all assessment domains in both accredited and nonaccredited hospitals in comparison with the government sector. Accredited government hospitals scored higher in patients' evaluation for "doctor and nurse," "investigations," "pain," and "overall respect of medical staff" domains than nonaccredited government hospitals. The overall experience was significantly different between accredited and nonaccredited government hospitals. Quality of emergency care services should be assessed through various dimensions related to patients' perspectives. Patients' perception toward the quality of emergency health services is evidently enhanced by accreditation especially in the government sector.

Does Accreditation Symbolise Quality in Public Healthcare Delivery? An Investigation of Hospitals in Kerala

Accreditation has become an important benchmark for healthcare organisations, and accordingly, many government hospitals in Kerala got accredited with national level (National Accreditation Board for Hospitals &amp; Healthcare Providers [NABH]) and state level (Kerala Accreditation Standards for Hospitals [KASH]) accreditation programmes. This study examined the quality of public healthcare delivery in these accredited hospitals while having a comparison with the non-accredited hospitals. It also compared the impact of national and state-level accreditation programmes in Kerala public healthcare settings. This cross-sectional study conducted between July 2017 and July 2018, employing a positivist approach using stratified random sampling. In total, 621 samples were collected from inpatients of both accredited (NABH and KASH) (312) and non-accredited (309) public healthcare institutions in Kerala. Nine constructs overarching the quality of healthcare delivery and patient satisfaction construct are used in the study. The study found that patient satisfaction is identical in both accredited and non-accredited hospitals ( M = 4.28). Patient satisfaction in NABH accredited hospital ( M = 4.27 ± 0.67874) is lower than that of KASH accredited hospital ( M = 4.30 ± 1.25417). The mean score of six constructs of quality healthcare delivery of KASH accredited hospitals is higher than NABH accredited. The study revealed that accreditation brings improvement in certain dimensions of healthcare delivery but does not bring a holistic change. The study concluded that if accreditation has to symbolize quality healthcare delivery, infrastructural and interpersonnel components of healthcare delivery must be improved.

Assessment and patients perception of the impact of accreditation on the quality of public healthcare delivery in primary and secondary healthcare settings

Accreditation is a crucial component that stresses patient safety and service quality. The goal of this study was to fill in the gaps by evaluating the impact of accreditation in primary and secondary public health care settings. A survey questionnaire was used to perform this cross-sectional study from July 2017 to July 2018. The study used a positivist paradigm, examining quantitative indicators before and after the certification procedure to determine the influence of accreditation.Due to the fact that the data were not normally distributed, the variables were measured on an ordinal scale, the observations from both groups were independent of one another, and the distribution of the variable was similar in each group, the Kruskal– Wallis test was used to determine statistical significance. The mean score for components spanning structural, procedural, and outcome domains has been calculated for certified and non-accredited hospitals. Certified hospitals have higher median values for all structures in primary health-care facilities than non-accredited hospitals. Most of the constructs have a lower or equal median value in accredited secondary care facilities than in non-accredited facilities. Accreditation has the potential to have a positive impact on the entire facility. Nonetheless, authorities must see accreditation as a way of holistic and continual reform if they are to ensure the intended outcome from this lengthy and costly procedure.

Nurses' Application of International Patient Safety Goals at Accredited and Non-accredited Hospitals

Background: Patient safety is an essential component in the quality of patient care. Itremains a challenge for developing countries. Assessment of application of international patientsafety goals in healthcare organizations is becoming an integral component to improve patients'safety. The study aimed to assess nurses’ application of international patient safety goals ataccredited and non-accredited hospitals. Research design: A comparative design was utilized toconduct this study. Setting: The study was conducted at general intensive care units (ICU) in BenhaUniversity Hospital (non-accredited hospital) and Elaraby International Hospital (accreditedhospital). Sample: All available 112 staff nurses working at the above mentioned settingsdistributed as following 60 staff nurses at Benha University Hospital and 52 staff nurses' at ElarabyInternational Hospital. Tools for data collection: Three tools were used. I: Personal and workcharacteristics of studied staff nurses, II: International patient safety goals’ questionnaire and III:Observational checklist for international patient safety goals practice. Results: 97.8% & 94.3% ofstudied staff nurses had good knowledge and competently applied practice level at accreditedhospital respectively. While, 30.1% had good knowledge and 76.1%of them had incompetentlyapplied practice level at non-accredited hospital about international patient safety goals.Conclusion: There was a positive statistical significance correlation between studied staff nurses'knowledge and practice of international patient safety goals at accredited and non-accreditedhospitals. There was highly statistical significance difference between accredited and nonaccredited hospitals regarding knowledge and practice of international patient safety goals amongstudied staff nurses. Recommendations: Educational programs and training courses should bedeveloped and implemented for staff nurses' about application of international patient safety goalsand how it can be used to improve patient safety at non-accredited hospitals

Comparison of Major Clinical Outcomes between Accredited and Nonaccredited Hospitals for Inpatient Care of Acute Myocardial Infarction.

Hospital accreditation programs are used worldwide to improve the quality of care and improve patient safety. It is of great help in improving the structure of hospitals, but there are mixed research results on improving the clinical outcome of patients. The purpose of this study was to compare the levels of core clinical outcome indicators after receiving inpatient services from accredited and nonaccredited hospitals in patients with acute myocardial infarction (AMI). For all patients with AMI admitted to general hospitals in Korea from 2010 to 2017, their 30-day mortality and readmissions and length of stay were compared according to accreditation status. In addition, through a multivariate model that controls various patients’ and hospitals’ factors, the differences in those indicators were analyzed more accurately. The 30-day mortality of patients admitted to accredited hospitals was statistically significantly lower than that of patients admitted to nonaccredited hospitals. However, for 30-day readmission and length of stay, accreditation did not appear to yield more desirable results. This study shows that when evaluating the clinical impact of hospital accreditation programs, not only the mortality but also various clinical indicators need to be included, and a more comprehensive review is needed.

Racial/Ethnic Disparities in Survival after Breast Cancer Diagnosis by Estrogen and Progesterone Receptor Status: A Pooled Analysis.

Limited studies have investigated racial/ethnic survival disparities for breast cancer defined by estrogen receptor (ER) and progesterone receptor (PR) status in a multiethnic population. Using multivariable Cox proportional hazards models, we assessed associations of race/ethnicity with ER/PR-specific breast cancer mortality in 10,366 California women diagnosed with breast cancer from 1993 to 2009. We evaluated joint associations of race/ethnicity, health care, sociodemographic, and lifestyle factors with mortality. Among women with ER/PR+ breast cancer, breast cancer-specific mortality was similar among Hispanic and Asian American women, but higher among African American women [HR, 1.31; 95% confidence interval (CI), 1.05-1.63] compared with non-Hispanic White (NHW) women. Breast cancer-specific mortality was modified by surgery type, hospital type, education, neighborhood socioeconomic status (SES), smoking history, and alcohol consumption. Among African American women, breast cancer-specific mortality was higher among those treated at nonaccredited hospitals (HR, 1.57; 95% CI, 1.21-2.04) and those from lower SES neighborhoods (HR, 1.48; 95% CI, 1.16-1.88) compared with NHW women without these characteristics. Breast cancer-specific mortality was higher among African American women with at least some college education (HR, 1.42; 95% CI, 1.11-1.82) compared with NHW women with similar education. For ER-/PR- disease, breast cancer-specific mortality did not differ by race/ethnicity and associations of race/ethnicity with breast cancer-specific mortality varied only by neighborhood SES among African American women. Racial/ethnic survival disparities are more striking for ER/PR+ than ER-/PR- breast cancer. Social determinants and lifestyle factors may explain some of the survival disparities for ER/PR+ breast cancer. Addressing these factors may help reduce the higher mortality of African American women with ER/PR+ breast cancer.

Impact assessment of accreditation in primary and secondary public health-care institutions in Kerala, India.

Accreditation has become a benchmark for health-care organizations that require huge investment and effort. The impact of accreditation in health-care delivery needs to be assessed. The study aimed to assess the impact of accreditation on the quality of public healthcare delivery in primary and secondary healthcare settings in Kerala. This cross-sectional study was conducted from July 2017 to July 2018 among 621 in-patients in medical wards at accredited (312) and nonaccredited (309) primary (community health center) and secondary (general, women and children, and taluk level hospitals) public health-care facilities. Ten constructs such as physical facility, admission services, patient centeredness, accessibility of medical care, financial matters, professionalism, staff services, medical quality, diagnostic services, and patient satisfaction were used in the study. Nonaccredited and accredited hospitals were compared using Median and Kruskal-Wallis test using SPSS version 22, with a set significance level of P ≤0 .05. The median score of constructs of accredited primary health-care facilities in the Structure, Process, and Outcome domains are higher than the nonaccredited hospitals. There are significant differences between the scores of these three domains in accredited and nonaccredited primary health-care institutions but absent in secondary care institutions. If accreditation has to bring the embedded quality, structural, and procedural aspects of health-care facilities must be improved. Structural upgradation of a health-care facility alone cannot guarantee patient satisfaction. Accreditation process must be perceived as a tool for holistic and continuous transformation of a health-care facility overarching infrastructural and interpersonal domains.

Exploring quality management system maturity of the accredited hospitals

To explore the level of quality management system (QMS) implementation across hospital accreditation status. Sixteen hospitals in three districts in East Java, agreed to participate in this study. This study involved nurses who were asked to give their responses in five scales for each component of QMS. A cross-tabulation was created to describe the QMS maturity across hospital accreditation status. Regardless of accreditation status, documentation, and credential mechanism were the QMS components that mostly perceived were already at a mature level. The accredited hospitals still have problem in continuous measure and use professional opinion for continuous quality improvement; while, non-accredited hospitals do not have approves quality improvement plans. Even in hospitals with full accreditation stage, not all QMS components have been in mature levels. The accreditation program has induced the QMS implementation but still limited in planning and procedural documentation.

Effects of National Hospital Accreditation in Acute Coronary Syndrome on In-Hospital Mortality and Clinical Outcomes.

Acute coronary syndrome (ACS) is a life-threatening medical condition that accounts for an annual expenditure of more than $300 billion in the United States. Hospital accreditation has been shown to improve patient and hospital outcomes for various conditions. This study aimed to determine the benefits of hospital accreditation in patients with ACS. This nationwide population-based cohort study used Taiwan's National Health Insurance Research Database from 1997 to 2011 (n = 249,354). Multivariable logistic regression was used to analyze the risk of in-hospital events among those treated in accredited and non-accredited hospitals, and to compare outcomes in hospitals before and after accreditation. The effect of accreditation on these events was also stratified by accreditation grade. A total of 823 hospitals were included, of which 2.4% were medical centers, 13.7% were regional hospitals, and 83.8% were district hospitals. The in-hospital mortality [odds ratio (OR), 0.82; 95% confidence interval (CI), 0.79-0.85; p < 0.001] and recurrent acute myocardial infarction (AMI) admission (OR, 0.81; 95% CI, 0.71-0.93; p = 0.003) rates were significantly lower in the after-accreditation group than in the before-accreditation group. There was a substantial and marked decrease in the in-hospital mortality rate after accreditation in 2008. This cohort study demonstrated that ACS accreditation was associated with better in-hospital mortality and recurrent AMI admission rates in ACS patients.