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Table 1 Characteristics of Included Studies

From: Variation in clinical outcomes and process of care measures in community acquired pneumonia: a systematic review

Author & Year Study Design Country Number of subunit compared Total study population Quality score POC, Outcome or Both Variation in Patient population between units Variation in hospital type / subunit Variation in disease factors
Subunit of variation: Geographical region or country
 Arnold et al. [12] 2013 Retrospective Cohort International – 16 countries across USA, Canada, Europe and Latin America 70 hospitals across 3 geographical regions (USA/Canada, Europe, Latin America) 6371 9.5 Both Significant differences in baseline populations. Latin America lowest prevalence of every co-morbidity. Variation between hospitals grouped by continents. International variation in healthcare practice and resources. Europe - fewest low severity scoring patients, greatest number of high severity scoring patients.
 Blasi et al. [13] 2013 Retrospective Cohort International - Europe 10 countries (128 sites) 2039 6.5 Outcome Not reported Not reported Included HCAP in addition to CAP
 Lave et al. [23] 1996 Retrospective Analysis of Administrative data USA 7 geographical regions 36,222 7 Both Not reported All hospitals part of a larger non-profit organisation. Bed size varies 80–500 beds. Teaching and non-teaching facilities. Not reported
 Remond et al. [27] 2010 Mixed Prospective / Retrospective Cohort Australia 2 regions (7 hospitals) 293 6.5 Both Different ethnicity between cohorts Six small regional hospitals in the Kimberley, one tertiary hospital in Central Australia Regional differences in isolated causative organisms.
Subunit of variation: Hospital
 Aelvoet et al. [11] 2016 Retrospective Analysis of Administrative data Belgium 111 hospitals 108,213 7 Outcome Not reported All hospitals in Belgium Not reported
 Cabre et al. [14] 2004 Retrospective Cohort Spain 27 hospitals 1920 6.5 Both The number of comorbidities varied among hospitals. All community hospitals - urban and rural Proportion of patients belonging to each risk class (by PSI) varied widely among hospitals
 Capelastegui et al. [15] 2005 Retrospective Cohort Spain 5 hospitals 1498 6 Both Statistically significant differences in patient demographic factors between hospitals. All teaching general hospitals with similar resources Statistically significant differences in PSI score classification between hospitals
 Dedier et al. [16] 2001 Retrospective Cohort USA 38 hospitals 1062 5 Both Not reported All academic hospitals Not reported
 Feagan et al. [17] 2000 Retrospective Cohort Canada 20 hospitals 858 6.5 Both Only comparison reported between teaching and general hospital populations 11 teaching hospitals, 9 community hospitals Not reported
 Fine et al. [10] 1993 Prospective Cohort USA 4 hospitals 552 9.5 Both Mean number of comorbid conditions per patient varied significantly among hospitals. 2 university hospitals, one veterans hospitals, one community hospital Disease severity and aetiology similar across hospitals
 Garau et al. [18] 2008 Retrospective Cohort Spain 10 hospitals 3233 8 Outcome Not reported All tertiary hospitals Proportion of patients belonging to each PSI class varied widely across hospitals, as did the proportion with an aetiological diagnosis.
 Gilbert et al. [19] 1998 Prospective Cohort USA/Canada 4 hospitals 1328 9.5 Both Significant differences in mean age, gender, racial distribution and comorbidities among the 4 sites. Three university teaching hospitals, one community teaching Statistically significant differences in causative organisms identified and severity of illness.
 Hedlund et al. [20] 2002 Retrospective Cohort Sweden 17 hospitals 982 5 Outcome   Seven university hospitals, 10 county hospitals. The mean PSI varied between 0.9 and 1.9 at different sites
 Iroezindu et al. [21] 2016 Prospective Case control Nigeria 4 hospitals 400 6 Outcome Not reported All tertiary hospitals Not reported
 Klausen et al. [31] 2012 Retrospective Analysis of Administrative data Denmark 22 hospitals 11,322 8.5 Outcome Not reported All Danish public health hospitals Not reported
 Laing et al. [22] 2004 Prospective Cohort New Zealand 2 hospitals 474 7 Both Similar demographics between the two populations except significant differences in ethnicity and rates of COPD. “Similar institutions” No significant differences in disease severity by PSI.
 Malone et al. [24] 2001 Retrospective Cohort USA 5 hospitals 330 (52 severe) 5.5 POC Not reported All acute care facilities (Centura) Not reported
 McCormick et al. [25] 1999 Prospective Cohort USA/Canada 4 hospitals 1188 9 Both A younger more mixed-race population identified at one site. The proportion admitted from a nursing home varied from 9 to 16%. Three university teaching hospitals, one community teaching Severity of illness and symptom profiles were similar across hospitals. One hospital had fewer “high risk” aetiology.
 Menendez et al. [26] 2003 Prospective Cohort Spain 4 hospitals 425 7 NA Not reported Not reported Not reported
 Reyes Calzada et al. [28] 2007 Prospective Cohort Spain 4 hospitals 425 6 Both No significant differences in co-morbidity, age and sex. Smoking significantly more frequent in two hospitals. One tertiary and 3 district general hospitals Not reported
 Schouten et al. [29] 2005 Analysis of baseline population from RCT Netherlands 8 hospitals 436 6.5 POC Not reported Eight medium sized hospitals in the south-east of the Netherlands Not reported
 Sow et al. [30] 1996 Prospective Cohort France and New Guinea 2 hospitals 333 5 Outcome Mean age and pre-existing illness rate was significantly lower in Guinea than France. One hospital in the Republic of Guinea compared to one in France Similar severity between cohorts (clinical definition not validated severity score)
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Pneumonia

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