Reporting Information System Research Articles

Voluntary Neonatal Medication Incident Reporting—A Single Centre Retrospective Analysis

Background: Medication errors in neonatal intensive care units (NICUs) are prevalent, with dosage and prescription errors being the most common. Aims: To identify the common medication errors reported over twelve years using a voluntary, nonanonymous incident reporting system (RiskMan clinical incident reporting information system) at an Australian tertiary NICU. Methods: This was a single-centre cohort study conducted at a tertiary NICU. All medication-related incidents (errors) reported prospectively through the RiskMan online voluntary reporting database from January 2010 to December 2021 were included. The medication incidents were grouped into administration, prescription, pharmacy-related, and others, which included the remaining uncommon incidents. Results: Over the study period, 583 medication errors were reported, including administration-related (41.3%), prescription-related (24.5%), pharmacy-related (10.1%), and other errors (24%). Most incidents were reported by nursing and midwifery staff (77%) and pharmacists (17.5%). Most outcomes were minor or insignificant (98%), with only a few resulting in major or significant harm. There was one extreme incident that may have contributed to the death of a neonate and nine moderate incidents. Conclusions: Our results demonstrate that medication errors are common and highlight the need to support improvement initiatives and implement existing evidence-based interventions in routine practice to minimise medication errors in the NICU.

Comparison of Three Influenza Surveillance Data Sources for Timely Detection of Epidemic Onset - Chengdu City, Sichuan Province and Beijing Municipality, China, 2017-2023.

The syndromic surveillance system, exemplified by the influenza-like illness (ILI) surveillance system, has long been crucial in providing early warnings of influenza epidemics. The analysis revealed that employing reported influenza case data from the nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS) enhanced the early detection of influenza epidemics, particularly within the context of multiple respiratory pathogens circulating concurrently. The NIDRIS, characterized by its extensive coverage, obligatory reporting, high specificity, and real-time data transmission, offers a valuable tool for the effective early detection of influenza epidemics. Utilizing this system could enhance preparedness and responses to such health crises, potentially mitigating their impact on public health.

Epidemiological Characteristics and Spatiotemporal Patterns of Visceral Leishmaniasis in Xinjiang, China, during 2004-2021.

The spread of visceral leishmaniasis (VL), a serious global zoonotic parasitic disease, is mostly under control; however, several cases have been reported in recent decades in Xinjiang, China. This study aimed to analyze the epidemiological status and spatiotemporal clustering characteristics of VL in Xinjiang, China, between 2004 and 2021 to provide a basis for the development and implementation of surveillance and response measures. Data on VL incidence during 2004-2021 were collected from the National Diseases Reporting Information System of China. Global spatial autocorrelation analysis, identification of local indicators of spatial association, and spatial-temporal clustering analysis were conducted to identify the distribution and high-risk areas. A total of 2034 VL cases were reported, with a mean annual incidence of 0.50 per 100,000. There was a general decreasing trend in the incidence of VL during our study period. The majority of the cases were reported from October to February of the following year, and fewer cases were reported from April to July. Spatial autocorrelation analysis revealed that the incidence of VL was spatially clustered within a few counties. Significant differences were observed during the study period (Moran's I = 0.74, Z = 4.900, p < 0.05). The male-to-female ratio was 1.37:1, and most patients were in the age group 0-3 years. Cases were primarily distributed in seven regions and two autonomous prefectures, and Kashgar reported the highest number of cases (1688, 82.98%). Spatial analysis revealed that the aggregation of VL was predominantly observed in southwest Xinjiang. This was in alignment with the high-risk areas identified by spatiotemporal clustering analysis. The H-H clustering region was primarily observed in Gashi, Atushi, Shufu, Injisha, Kashgar, Yepuhu, and Bachu. These findings indicate that integrated control measures must be taken in different endemic areas to strengthen the VL control program in Xinjiang, China.

Aplikasi Sistem Laporan Kerja Harian Staf Pelayanan PT. Securindo Packatama Indonesia Berbasis Web dengan Metode Rapid Application Development

This study aims to develop a web-based daily work report information system that is more effective, efficient, and computerized. The application is designed to assist service staff in preparing daily reports and provides a data backup medium for work programs. The study employs the Rapid Application Development (RAD) method, which emphasizes fast development through iterative prototyping and active user involvement. RAD consists of several phases, including planning, design workshops, and implementation, allowing continuous user feedback to incrementally improve the system. Data was collected through field studies with direct observation, discussions with colleagues, and interviews with relevant parties. The application was built using PHP and MySQL and tested comprehensively to ensure performance and accuracy. The study concludes that the system effectively facilitates report recapitulation and performance data presentation, improving operational efficiency at PT. Securindo Packatama Indonesia.

Sistem Informasi Pelaporan Perkembangan Pasien (SI-PELPASI) berbasis Mobile Android

The use of Android mobile applications in the healthcare sector as tools for patient progress reporting has become a significant innovation. The mobile Android-based patient progress reporting information system (SI-PELPASI) serves as a solution to enhance efficiency and accuracy in patient monitoring. This study aims to develop a mobile Android-based patient progress reporting information system at the Bukit doa rehabilitation centre, an Institution for Mandatory Reporting (IPWL). The system development in this study employs the System Development Life Cycle (SDLC) method, which consists of systematic stages: the planning stage aims to plan the system, the analysis stage involves reviewing existing and current systems and collecting data through interviews and observations, the design stage includes designing Unified Modelling Language (UML) diagrams and the user interface, the implementation stage uses the Kodular app creation platform, and the testing stage uses the black box method to test system functionality. Our findings resulted in the Patient Progress Reporting Information System in the form of a Mobile Android application named SI-PELPASI. The application runs smoothly and can be operated on Android-based mobile devices. With this application, the process of reporting patient progress becomes faster and real-time.

Retrospective estimation of the time-varying effective reproduction number for a COVID-19 outbreak in Shenyang, China: An observational study.

The time-varying effective reproduction number Re(t) is essential for designing and adjusting public health responses. Retrospective analysis of Re(t) helps to evaluate health emergency capabilities. We conducted this study to estimate the Re(t) of the Corona Virus Disease 2019 (COVID-19) outbreak caused by SARS-CoV-2 Omicron in Shenyang, China. Data on the daily incidence of this Corona Virus Disease 2019 outbreak between March 5, 2022, and April 25, 2022, in Shenyang, China, were downloaded from the Nationwide Notifiable Infectious Diseases Reporting Information System. Infector-infectee pairs were identified through epidemiological investigation. Re(t) was estimated by R-studio Package "EpiEstim" based on Bayesian framework through parameter and nonparametric method, respectively. About 1134 infections were found in this outbreak, with 20 confirmed cases and 1124 asymptomatic infections. Fifty-four infector-infectee pairs were identified and formed a serial interval list, and 15 infector-infectee pairs were included in the generation time table. Re(t) calculated by parameter and nonparametric method all peaked on March 17, 2022, with a value of 2.58 and 2.54 and decreased to <1 after March 28, 2022. There was no statistical difference in the Re(t) distribution calculated using the 2 methods (t = 0.001, P > .05). The present study indicated that the decisive response of Shenyang, China, played a significant role in preventing the spread of the epidemic, and the retrospective analysis provided novel insights into the outbreak response to future public health emergencies.

DEVELOPMENT OF A DESKTOP-BASED INFORMATION SYSTEM FOR REPORTING STUDENT LEARNING RESULTS AT SMK NEGERI 1 TINAMBUNG

This research aims to determine: (1) the stages of developing a desktop-based information system for reporting student learning outcomes at SMK Negeri 1 Tinambung, and (2) the efficiency of developing a desktop-based information system for reporting student learning outcomes at SMK Negeri 1 Tinambung. The research method used is the Research and Development (R&amp;D) method. The process of developing a desktop-based student learning outcomes report at SMK Negeri 1 Tinambung refers to the ADDIE development model including the analysis stage, design stage, development stage, implementation stage, and evaluation stage. The results of the research show that the development of a desktop-based student learning outcomes report information system at SMK Negeri 1 Tinambung is said to be efficient based on the Usability aspect test which includes the Usefulness aspect, the Ease-of-Use aspect, the Ease of Learning aspect, and the Satisfaction aspect. The information system for reporting student learning outcomes is said to be efficient because it is in the very good category. It is hoped that this system can make it easier for users to process student learning outcomes reports at SMK Negeri 1 Tinambung.

Implementasi Sistem Informasi Raport Online Berbasis Website untuk Meningkatkan Efisiensi dan Aksesibilitas Pengelolaan Nilai Siswa di Sekolah Menengah Pertama

The current method of recording student grades at Kallista School is not fully computerized. Grades are manually entered into report books, which, when errors or mistakes occur, result in disorganized report content. Additionally, the extensive and complex recording of student data, attendance, class schedules, subjects, and grades in the junior high school's ledger book poses difficulties in data processing in case of errors in both recording and managing large-scale data. Therefore, it is imperative for the school to provide a service that offers rapid, easy, practical, and efficient access to report card information for students and their parents or guardians. This information system is designed as a website using PHP programming language and MySQL database. The implementation of this online report information system facilitates the tasks of teachers and administrative staff in fulfilling their responsibilities, while enabling parents to easily, quickly, and economically access school report information from anywhere, anytime, transcending geographical and temporal constraints.

Rancang Bangun Sistem Informasi Laporan Keuangan Bulanan Pesantren di Kantor Kepesantrenan Putri

This research is the design of a monthly financial reporting information system for Islamic boarding schools at the Girls' Islamic Boarding School office, which was built using the PHP programming language. This information system will henceforth be named SIM-KA (Financial and Budget Management Information System). SIM-KA is accessed using the local network of the women's boarding school office. The financial reporting and budgeting of female Islamic boarding schools is still less than optimal, and errors often occur in the amounts reported. It is hoped that the design of this information system will (1) help Islamic boarding school administrators in reporting and making Islamic boarding school budgets so that they are more optimal, (2) help speed up work in making monthly Islamic boarding school reports and budgets, and (3) reduce errors in calculating recapitulation reports and budgets.

Epidemiological characteristics of typhoid fever in Fujian Province, 2011-2022

Objective: To analyze the incidence trend and epidemiological characteristics of typhoid fever in Fujian Province from 2011 to 2022, and understand the high-incidence population and hotspot areas, and provide evidences to develop more targeted prevention and control measures. Methods: The surveillance data of typhoid fever during 2011-2022 in Fujian Province were obtained from the National Disease Reporting Information System and analyzed with SAS 9.4. The spatial autocorrelation analysis of typhoid fever incidence at county/district levels was performed with ArcGlS 10.8. Results: A total of 5 126 cases of typhoid fever were reported in Fujian Province from 2011 to 2022, with an average annual incidence rate of 1.10/100 000. The average annual incidence rate was 0.96/100 000 from 2011 to 2015, 1.49/100 000 from 2016 to 2019, and 0.81/100 000 from 2020 to 2022. The disease occurred all the year round, with high epidemic season from May to September. A total of 23.59% (1 209/5 126) of the cases occurred at the age of 0-4, and 9.62% (493/5 126) at the age of 5-9. The male to female ratio of the cases was 0.97∶1 (2 524∶2 602) for the whole population, 1.19∶1 (925∶777) for people under 10 years old, 0.75∶1 (1 060∶1 404) for people between 10 and 54 years old, and 1.28∶1 (539∶421) for people over 55 years old. Cases in Ningde City accounted for 30.65% (1 571/5 126) of the total cases. Most hotspots were occurred in Ningde City. Recurrent and clustered cases were found in family members. Conclusions: Typhoid fever was prevalent at a low level in Fujian Province during 2011-2022, indicating that strengthening the prevention and control measures should target key areas and populations. The incidence of typhoid fever in Fujian Province showed spatial aggregation phenomenon, and most cases gathered in Ningde City. Intensive study for the influencing factors of spatial clustering should be conducted.

REPORT INFORMATION SYSTEM DESIGN BANGAH VILLAGE FINANCE USING WORDPRESS CMS

Financial reports are a very crucial aspect because they require clear and transparent reporting. However, the community in Bangah Village, especially RT 06 RW 07, Bangah Village, Gedangan District, Sidoarjo Regency, does not yet have a financial reporting information system that meets their needs. Therefore, this research aims to build a financial reporting information system that can report finances systematically and transparently. It is hoped that with this financial reporting information system, the community in Bangah Village can obtain financial reports that are more accurate and easily accessible, as well as increasing transparency and efficiency in managing village finances.

The Revival of US Hospital Care, 2004-2019.

Between 2004 and 2019, the US hospital industry reversed the 21-year decline in its share of national health spending. To measure and explain changes in hospital utilization, cost, charges, and inpatient case mix. Principal sources were the American Hospital Association annual survey, the National Inpatient Sample, and the Healthcare Cost Reporting Information System. The study included all US community hospitals (n=5141 in 2019). We used factor decomposition to separate the impacts of population, utilization, unit cost, and charge markups on the growth in cost and charges for inpatient and outpatient care nationwide and for each state. For unit cost, we separated the impacts of input price inflation and treatment intensity. To measure the inpatient case mix, we applied an all-patient diagnosis-related groups algorithm. Between 2004 and 2019, charges more than tripled to $4.11 trillion. The cost more than doubled to $911 billion. For inpatient care, discharges fell 5%, discharges per person fell 15%, cost per discharge increased 88%, and charge markups rose 43%. For outpatient care, visits rose 36%, visits per person rose 21%, cost per visit rose 119%, and charge markups rose 52%. Treatment intensity increased by 33% per discharge and 55% per visit. Nationwide, the inpatient case mix increased by 34%, reflecting sicker patients and better clinical documentation. We quantified 3 important trends: rapid growth in outpatient visits, increased treatment intensity, and sustained increases in markups. Increased treatment intensity was the largest factor behind $491 billion in hospital cost growth between 2004 and 2019.

Sistem Informasi Pelaporan Lapinhar, Lapinsus, dan Lapbangsit di Kejaksaan Negeri Penajam Paser Utara Berbasis Web

This study aims to analyse the Web-Based Lapinhar, Lapinsus, and Lapbangsit Reporting Information System at the Penajam Paser Utara District Attorney's Office. This information system is a tool for presenting information in such a way that it is useful for the recipient through the services available in this system. The research site was conducted at the North Panajam Paser State Attorney's Office. Data collection methods are observation, interviews. Secondary data of this research is obtained from books, journals, and previous research. The result of this research is that a web-based information system has been successfully developed which aims to simplify the process of reporting and managing data in three important fields in the North Penajam Paser State Attorney's Office, namely Lapinhar (General Criminal Report), Lapinsus (Special Criminal Report), and Lapbangsit (System Build Report). Through careful analysis and design, this information system provides an effective solution in overcoming the obstacles that existed in the previous manual system.

Epidemiological features of seasonal influenza transmission among 11 climate zones in Chinese Mainland

BackgroundPrevious studies provided some evidence of meteorological factors influence seasonal influenza transmission patterns varying across regions and latitudes. However, research on seasonal influenza activities based on climate zones are still in lack. This study aims to utilize the ecological-based Köppen Geiger climate zones classification system to compare the spatial and temporal epidemiological characteristics of seasonal influenza in Chinese Mainland and assess the feasibility of developing an early warning system.MethodsWeekly influenza cases number from 2014 to 2019 at the county and city level were sourced from China National Notifiable Infectious Disease Report Information System. Epidemic temporal indices, time series seasonality decomposition, spatial modelling theories including Moran’s I and local indicators of spatial association were applied to identify the spatial and temporal patterns of influenza transmission.ResultsAll climate zones had peaks in Winter-Spring season. Arid, desert, cold (BWk) showed up the first peak. Only Tropical, savannah (Aw) and Temperate, dry winter with hot summer (Cwa) zones had unique summer peak. Temperate, no dry season and hot summer (Cfa) zone had highest average incidence rate (IR) at 1.047/100,000. The Global Moran’s I showed that average IR had significant clustered trend (z = 53.69, P < 0.001), with local Moran’s I identified high-high cluster in Cfa and Cwa. IR differed among three age groups between climate zones (0–14 years old: F = 26.80, P < 0.001; 15–64 years old: F = 25.04, P < 0.001; Above 65 years old: F = 5.27, P < 0.001). Age group 0–14 years had highest average IR in Cwa and Cfa (IR = 6.23 and 6.21) with unique dual peaks in winter and spring season showed by seasonality decomposition.ConclusionsSeasonal influenza exhibited distinct spatial and temporal patterns in different climate zones. Seasonal influenza primarily emerged in BWk, subsequently in Cfa and Cwa. Cfa, Cwa and BSk pose high risk for seasonal influenza epidemics. The research finds will provide scientific evidence for developing seasonal influenza early warning system based on climate zones.

Increasing ratio of opportunistic infections associated with sunshine exposure and economic level burdening Chinese inflammatory bowel disease hospitalized patients: the first nationwide survey from 2014 to 2019

BackgroundThe rising prevalence of opportunistic infections (OIs) in inflammatory bowel disease (IBD) in conjunction with the use of biologics/immunosuppressive agents has garnered attention. However, there is a dearth of research on OIs in Mainland China. This study seeks to evaluate the national ratio trend of OIs in IBD and elucidate the influence of economic and climate factors on IBD patients with OIs and their outcomes.MethodsThe nationwide data was obtained from the Inpatient medical record home page via the Health Statistics and Information Reporting System (HSRS). Patients diagnosed with IBD were enlisted for participation, and their demographic and clinical information, encompassing infection type, surgical procedures, and expenses, were gathered. The National Bureau of Statistics provided data on monthly sunshine exposure hours and yearly Gross Domestic Product (GDP).ResultsFindings indicate that between 2014 and 2019, a total of 381,752 patients with IBD were admitted to hospitals, with 364,249 patients lacking OIs and 17,503 patients presenting with OIs. The annual proportion of OIs exhibited an upward trend, rising from 3.54% in 2014 to 4.81% in 2019. There was a significant correlation observed between individuals who identified as male, those who visited hospitals in southern regions, or those originating from areas with lower GDP or shorter sunshine exposure hours, and a higher incidence of OIs. Among patients diagnosed with either Crohn’s disease (CD) or ulcerative colitis (UC), Clostridium difficile was found to be the most prevalent infection, followed by Epstein-Barr virus and cytomegalovirus. Furthermore, the occurrence of OIs was found to be associated with an increased rate of surgical interventions in UC patients.ConclusionsThe rising prevalence of OIs among hospitalized patients with IBD necessitates heightened attention towards mitigating associated risk factors, particularly among IBD patients residing in less developed regions or experiencing limited exposure to sunlight. This approach aims to minimize hospital stays and associated costs.

Accounting Education in India: Opportunities and Challenges

Now-a-days accounting education is facing many challenges in view of revolutionary changes in accounting education. These are technological changes, professional changes, changes in business environment and updating accounting as science. The aim of accounting education is to enlighten the youngsters about advanced accounting knowledge and promoting the continuous organisational reforms in the area of accounting. Accounting as a reporting information system, the profession can cover micro and macro-economic activities in organisations. Against this backdrop, the paper makes an attempt to i) study and analyse the level of the accounting knowledge and technical knowledge possessed by the sample respondents, ii) examine the latest accounting knowledge among the sample respondents and iii) analysis opportunities and challenges in accounting education in India. The present study is empirical and descriptive in nature and based on primary and secondary data. The primary data is collected from students, research scholars, academicians, accounting practitioners and industry professionals through a structured questionnaire with the help of the Google Form. The secondary data is collected from articles, periodicals, magazines, newspaper, research journals and websites.

The Effect of Covid-19 Pandemic on Crimes in The Province of Isabela

This paper focuses on the effect of the COVID-19 pandemic on crimes, particularly on the prevailing crimes, crime trends, crime schemes or commissions, and the Police response to the crimes between non-pandemic and pandemic periods. The study used an explanatory sequential approach to reciprocally support groups of data. The quantitative data is taken from the PNP Crime Information Reporting and Analysis System (CIRAS) of cities and selected municipalities affected by COVID-19 in the Province of Isabela. The qualitative data were collected through a semi-structured interview with the Chief of Police and investigators of the station. The study revealed that homicide, rape, violation of RA No. 11332, and vehicular incidents were the most committed. Intoxication is the key player in crimes and a shift to the subject was noted. The upward trajectory of crime during the pandemic was interconnected with the violation of the Republic Act (R.A.) No. 11332 through disobedience and arrogance to the person in authority. Income-related crimes are noted to have just emerged while work-and-business-related crimes have gone during the pandemic. The crime trend shows that if the pandemic persists, crimes dynamically trail an upward trend. The PNP in the Province of Isabela strictly adheres to its mandates and shows resiliency in pandemic crimes and COVID-19.

Epidemiological Characteristics and Trends of Scarlet Fever in Zhejiang Province of China: Population-Based Surveillance during 2004-2022.

Over the past two decades, scarlet fever has resurged in some countries or areas. Nationwide nonpharmaceutical interventions changed the patterns of other infectious diseases, but its effects on the spread of scarlet fever were rarely studied. This study aimed to evaluate the changes in scarlet fever incidence in Zhejiang Province, China, before and during the COVID-19 pandemic periods and to provide references for scarlet fever prevention and control. Scarlet fever surveillance data in Zhejiang, China (2004-2022), were analyzed in three stages. Two-sample z test, ANOVA, and Tukey's test were used to compare and analyze the characteristics of disease spread at different stages. The ARIMA model was used to predict the overall trend. The data were obtained from the National Infectious Disease Reporting Information System. A total of 28,652 cases of scarlet fever were reported across Zhejiang Province during the study period, with the lowest average monthly incidences in 2020 (0.111/100,000). The predominant areas affected were the northern and central regions of Zhejiang, and all regions of Zhejiang experienced a decrease in incidence in 2020. The steepest decline in incidence in 2020 was found in children aged 0-4 years (67.3% decrease from 23.8/100,000 to 7.8/100,000). The seasonal pattern changed, with peak occurrences in April to June and November to January during 2004-2019 and 2021 and a peak in January in 2020. The median duration from diagnosis to confirmation was highest before COVID-19 (4 days); however, it decreased to 1 day in 2020-2022, matching the other two medians. In 2020, Zhejiang experienced an unprecedented decrease in scarlet fever, with the lowest incidence in nearly 18 years, but it rebounded in 2021 and 2022. The seasonal epidemiologic characteristics of scarlet fever also changed with the COVID-19 outbreaks. This suggested that nationwide nonpharmaceutical interventions greatly depressed the spread of scarlet fever. With the relaxation of non-pharmaceutical intervention restrictions, scarlet fever may reappear. Government policymakers should prioritize the control of future scarlet fever outbreaks for public health.

THE IMPACT OF CONTRACT NURSE UTILIZATION ON NURSING HOME QUALITY

Abstract Nurse staffing intensity and skill mix have a significant impact on NH quality of care. For instance, higher staffing levels, particularly for registered nurses (RNs), have been associated with better resident outcomes. NHs have increasingly relied on contract nurse staffing to address pressing and persistent nursing shortages. Research suggests that contract nurses may be unfamiliar with institutional policies and procedures or organizational culture. They may require increased supervision, be less participatory in teamwork, and may increase the workload for the permanent staff. The objective of this study is to examine the association between contract nurse utilization and quality of care at US nursing homes.We used secondary data from PBJ nurse staffing, Nursing Home Compare, Healthcare Cost Report Information System (HCRIS) Dataset, and the American Community Survey (ACS) for the period 2017-2021. The dependent variable was CMS quality star rating, and the independent variables were contract nurse to total nurse proportions for each of RNs, LPNs, and CNAs. We employed multivariate random effects ordered logistic regression to test the hypothesis. We found that across all our three models (RNs, LPNs, CNAs), quality star ratings were negatively associated with contract nurse utilization. A 10% increase in contract nurse proportion was associated with a 10% decrease in the odds of reporting a higher quality star rating (OR=0.99, p&amp;lt;0.001). Our results suggest the increased utilization of contract nurse staffing may have a negative impact on US NH quality---an important issue that has agitated policymakers for nearly three decades.

FROM COMFORT TO PROFITABILITY: RELATIONSHIP BETWEEN CARE QUALITY AND FINANCIAL PERFORMANCE IN US HOSPICES

Abstract Hospice care is a critical aspect of end-of-life care in the United States, providing comfort and support to individuals with life-limiting illnesses. Quality of care is a key concern for hospice facilities, as it can impact both patient outcomes and financial sustainability. Poor quality of care can lead to negative patient experiences, increased hospitalizations, and even legal issues. It can also result in financial penalties or reduced reimbursement from payers. However, there is limited research on the relationship between quality of care and financial performance in hospice facilities. Employing a cross-sectional observational design, we examined the relationship between Hospice and Palliative Care Composite Process Measure (lagged by 1 year) and the total margin of hospice facilities across the United States. We used secondary data from Nursing Home Compare, Healthcare Cost Report Information System Dataset, and the American Community Survey for the period 2017-2021. We found a positive association between quality process measures and financial performance in hospice facilities after controlling for organizational and community factors that may influence financial performance, such as facility size and location. Specifically, a 10-unit increase in quality measure was associated with a 2% increase in total margin. The findings of this study have important implications for the management and financing of hospice facilities. Investments in quality improvement initiatives may lead to improved financial performance. Policymakers should consider these findings when designing payment systems for hospice care, and administrators of hospice facilities should prioritize quality improvement initiatives to ensure both high-quality care and financial viability.