Check out hospital rating before checking in

Oct 17 2006

According to the latest study, the gap between the best and worst performing hospitals in the United States has widened by as much as 5 percent since last year.

The new report, Health Grade's Hospital Quality in America, has found that treatment outcomes at U.S. hospitals vary widely, and are dependent on which state, city or individual hospital provides the care.

It seems patients have a 69 percent lower risk of dying at "5-star" hospitals compared with "1-star" institutions, even though overall hospital death rates have dropped by almost 8 percent.

Health Grades is an independent health care ratings group and this latest annual report is their ninth.

The report based their assessment of the quality of care at more than 5,000 hospitals by analyzing 40.6 million Medicare hospital records from 2003 through 2005.

It uses a star rating system that tells people whether a particular hospital's performance has been "best" (5-star), "as expected" (3-star), or "poor" (1-star) on a particular procedure or diagnosis across 28 categories.

The ratings are based on patient outcomes, specifically, the risk of dying, or having serious complications.

Dr. Samantha Collier, Vice President of medical affairs at Health Grades, says across 28 conditions, such as heart failure and heart attack, and procedures, such as bypass surgery, and knee replacement, there is a large variation between hospitals and some of the differences can equate to as much as 90 percent.

The researchers estimate that were all hospitals 5-star rated, the lives of 302,403 Medicare patients could have been saved from 2003 through 2005.

The researchers also found that 50 percent of preventable deaths were linked to just four diagnoses: heart failure, community-acquired pneumonia, sepsis (blood infection) and respiratory failure.

To give an example, according to the report, a patient undergoing coronary bypass surgery has a 72.9 percent lower risk of dying if the procedure is done at a 5-star hospital, compared with a 1-star hospital and if all Medicare-covered bypass patients had the procedure done in 5-star hospitals, 5,308 lives would have been saved between 2003-2005.

Collier found that though the risk of dying in a hospital improved nearly 8 percent from 2003 to 2005, this improvement varied widely by procedure and diagnosis.

In addition, 5-star hospitals had significantly lower death rates for all three years of the study and showed a 19 percent improvement in quality compared to just "average" hospitals.

They also had a 57 percent gain in quality improvement over 1-star hospitals during the study period.

Collier says the reasons for the disparities are many, and include in-house management systems that don't adequately keep track of patients and treatments, and the understaffing or the use of doctors who are unskilled in a particular procedure.

The researchers advise patients to check out prospective hospitals before going in for a procedure and to also check out the hospital's record on that particular procedure.

Ratings for individual hospitals can be seen on the Health Grades web site (www.healthgrades.com).