Choosing the Right Hospital Increases Chance of
Survival by 70 Percent Says Annual Study
HealthGrades releases annual study; 41 million
patient records examined; national mortality rate improves
Oct. 14, 2008 – It is a headline that gets the
attention of senior citizens – “Death rate 70% lower at top-rated
hospitals” – since they are the heaviest users of hospital services. This
news is from one of the leading healthcare ratings organizations, HealthGrades, that today released its eleventh annual study of hospital
quality in America. It, along with Medicare, have become leaders in
grading hospital care.
The company derived the 70% lower chance of dying
by comparing death rates involving 17 procedures and conditions in what
it determined as the top-rated hospitals compared with the lowest
rated hospitals in the HealthGrades Hospital Quality in America Study,
issued today by HealthGrades.
While overall death rates declined from 2005 to
2007, the nation's best-performing hospitals were able to reduce their
death rates at a much faster rate than poorly performing hospitals,
resulting in large state, regional and hospital-to-hospital variations
in the quality of patient care, the study found.
The HealthGrades study also found that if all
hospitals performed at the level of five-star rated hospitals, 237,420
Medicare dealths could potentially have been prevented over the three
years studied.
More than half of those deaths were associated with
four conditions: sepsis (a life-threatening illness caused by systemic
response to infection), pneumonia, heart failure and respiratory
failure.
The HealthGrades study of patient outcomes at the
nation's approximately 5,000 hospitals is the most comprehensive annual
study of its kind, analyzing more than 41 million Medicare
hospitalization records from 2005 to 2007.
The American
Hospital Association is a partner of HospitalCompare.gov, and recommends
the federal report card site to patients. Government report cards such
as HospitalCompare.gov and state sites such as CalHospitalCompare.org
were among the highest-ranked report cards evaluated in a 2008 study by
the Healthcare Association of New York State.
The study examines procedures and conditions
ranging from heart valve-replacement surgery to heart attack to
pneumonia.
Based on the study, HealthGrades today made
available its 2009 quality ratings for all nonfederal hospitals in the
country at
www.healthgrades.com, a Web site designed to help individuals
research and compare local healthcare providers.
Full reports on death rate trends in each of the 50
states and the District of Columbia are available in the study.
And, for
the first time, HealthGrades has released hospital death rates for the
nation's 15 largest metropolitan statistical areas: New York, Los
Angeles, Chicago, Dallas, Philadelphia, Houston, Miami, Washington D.C.,
Atlanta, Boston, Detroit, San Francisco, Phoenix, Riverside-Inland
Empire (CA) and Seattle. Large variation exists between major
metropolitan areas.
"Geography should not be a major factor in
patients' outcomes. If our nation's hospitals are to close the quality
gap and guarantee an equally high level of medical care for every
patient, no matter where he or she lives, it will require a commitment
by our nation and its communities to demand more from quality
improvement," said Samantha Collier, MD, HealthGrades' chief medical
officer and a study author.
"Until then, it is imperative that anyone seeking
medical care at a hospital do their homework and know the hospital's
quality ratings before they check in."
The study's major findings are:
● The nation's inhospital risk-adjusted
mortality rate improved, on average, 14.17 percent from 2005 to 2007,
but the degree of improvement varied widely by procedure and diagnosis
studied (range: 6.30% to 20.94%). Five star-rated hospitals' mortality
rates continue to improve at a faster rate (13.18%) than 1- or 3-star
hospitals (12.30% and 13.14%, respectively).
● Large gaps persist between the "best" and the
"worst" hospitals across all procedures and diagnoses studied. Five
star-rated hospitals had significantly lower risk-adjusted mortality
across all three years studied. Across all procedures and diagnoses
studied, there was an approximate 70 percent lower chance of dying in a
5-star rated hospital compared to a 1-star rated hospital. Across all
procedures and diagnoses studied, there was an approximate 50 percent
lower chance of dying in a 5-star rated hospital compared to the U.S.
hospital average.
● If all hospitals performed at the level of a
5-star rated hospital across the 17 procedures and diagnoses studied,
237,420 Medicare lives could have potentially been saved from 2005 to
2007.
● Fifty-four percent (128,749) of the
potentially preventable deaths were associated with just four diagnoses:
Sepsis, heart failure, pneumonia and respiratory failure.
● Variation in risk-adjusted mortality exists
not only at the national level but also at the state and regional
levels. The greatest quality differences between states occurred in
hospital death rates for heart failure, pulmonary, stroke and cardiac
surgery.
● The region with the lowest overall
risk-adjusted mortality rates was the East North Central region (IL, IN,
MI, OH, and WI), while the East South Central region (AL, KY, MS, and
TN) had the highest mortality rates.
● The East North Central region (IL, IN, MI, OH,
and WI), had the highest percentage of best-performing hospitals at 26
percent. Less than seven percent of hospitals within the New England
region (CT, MA, ME, NH, RI, and VT) were top-performing hospitals.
In the study's analysis of hospital death rates,
the following 17 procedures and conditions were analyzed:
1. bowel obstruction,
2. chronic obstructive pulmonary disease,
3. coronary bypass surgery,
4. coronary interventional procedures (angioplasty/stent),
5. diabetic acidosis and coma,
6. gastrointestinal bleed,
7. gastrointestinal surgeries and procedures,
8. heart attack,
9. heart failure,
10. pancreatitis,
11. pneumonia,
12. pulmonary embolism,
13. resection/replacement of the abdominal aorta,
14. respiratory failure,
15. sepsis,
16. stroke, and
17. valve replacement surgery.
The full study, along with its methodology and
state-by-state hospital-quality statistics, can be found at
www.healthgrades.com.
Editor’s Notes:
HealthGrades' Star Ratings of Hospitals
On its Web site, HealthGrades offers, free to
consumers, quality ratings of 27 procedures and treatments for every
nonfederal hospital in the country. The Web site is designed so that
consumers can easily compare patient outcomes at their local hospitals
for procedures ranging from aortic aneurysm repair to bypass surgery.
Each hospital receives a star rating based on its patient outcomes in
terms of mortality or complication rates for each procedure or
treatment. Hospitals with outcomes that are above average to a
statistically significant degree receive a five-star rating. Hospitals
with average outcomes receive a three-star rating, and hospitals with
outcomes that are below average receive a one-star rating. Because no
two hospitals or their patients' risk profiles are alike, HealthGrades
employs extensive risk-adjustment algorithms to ensure that it is making
fair comparisons.
About HealthGrades
Health Grades, Inc. (Nasdaq: HGRD) is the leading
healthcare ratings organization, providing ratings and profiles of
hospitals, nursing homes and physicians. Millions of consumers and many
of the nation's largest employers, health plans and hospitals rely on
HealthGrades' independent ratings, advisory services and
decision-support resources to make healthcare decisions based on the
quality and cost of care. More information on the company can be found
at
www.healthgrades.com.
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