Top hospitals have 27 percent lower mortality: Annual HealthGrades study

Jan 29 2009

Medicare patients treated at top-rated hospitals nationwide across the most common Medicare diagnoses and procedures are 27 percent less likely to die, on average, than those admitted to all other hospitals, according to a study released today by HealthGrades, the leading independent healthcare ratings organization.

Patients who undergo surgery at these high-performing hospitals also have an average eight percent lower risk of complications during their stay.

The HealthGrades Seventh Annual Hospital Quality and Clinical Excellence study identifies hospitals in the top five percent nationally in terms of mortality and complication rates across 26 procedures and diagnoses, from heart attacks to total knee replacement. Hospitals achieving this level of care are designated as Distinguished Hospitals for Clinical Excellence™ by HealthGrades and are identified on the organization's consumer Web site, HealthGrades.com. Many hospitals excel in a given service line, but what differentiates these top hospitals is their quality achievement across a broad range of procedures and treatments.

The 2009 study of Medicare patients found that 152,666 lives may have been saved and 11,772 major complications avoided during the three years studied, had the quality of care at all hospitals matched the level of those in the top five percent. The difference between these top hospitals and the rest of the pack highlights a distinct gap between them.

Individuals can see how their local hospitals are rated, and if they have been designated Distinguished Hospitals for Clinical Excellence, for free at http://www.healthgrades.com .

"This study echoes others that have found distinct quality gaps between top-performing hospitals and others," said Rick May, MD, HealthGrades senior physician consultant and an author of the study. "Distinguished Hospitals for Clinical Excellence comprise a group of hospitals that excel across the board, not just in one or two specialties, and they should be commended for their relentless commitment to exceptional patient care."

In comparing hospitals in the top five percent, designated as Distinguished Hospitals for Clinical Excellence, with all other hospitals, the HealthGrades study found:

• On average, a 27 percent lower risk of inhospital risk-adjusted mortality was experienced by Medicare patients at Distinguished Hospitals for Clinical Excellence in the following procedures and diagnoses: cardiac surgery, angioplasty and stent, heart attack, heart failure, chronic obstructive pulmonary disease, pneumonia, stroke, abdominal aortic aneurysm repair, bowel obstruction, gastrointestinal surgeries and procedures, pancreatitis, diabetic acidosis and coma, pulmonary embolism, respiratory failure and sepsis.
• For those same procedures and diagnoses, Distinguished Hospitals for Clinical Excellence improved at a greater rate than other hospitals, lowering inhospital risk-adjusted mortality rates over the years 2005, 2006 and 2007 by an average 18 percent compared to 13 percent for all other hospitals.
• Medicare patients had, on average, an eight percent lower risk of inhospital complications at a Distinguished Hospital for Clinical Excellence for diagnoses and procedures that include orthopedic and neurosurgery, vascular surgery, prostate surgery and gall bladder surgery.
• For those same procedures and diagnoses, Distinguished Hospitals reduced inhospital complication rates by 3.92 percent from 2005 to 2007, compared to 2.51 percent for all other hospitals.

In its 2009 study, HealthGrades independently and objectively analyzed nearly 41 million patient records from the Centers for Medicare and Medicaid Services for fiscal years 2005, 2006 and 2007, for 26 medical procedures and diagnoses at every one of the nation's nearly 5,000 non-federal hospitals. To qualify for the list, hospitals were required to meet minimum thresholds in terms of patient volumes, quality ratings and the range of services provided. Prior to comparing the inhospital mortality and complication rates of the nation's hospitals, HealthGrades risk-adjusted the data, to compare on equal footing hospitals that treated sicker patients. Hospitals with risk-adjusted mortality and complication rates that scored in the top five percent or better nationally – which demonstrates superior overall clinical performance – were then recognized as Distinguished Hospitals for Clinical Excellence™.

HealthGrades' methodology can be found in the study and on the company's Web site.