Women and men experience different outcomes at U.S. hospitals for the same procedures and treatments, according to a new study released today by HealthGrades, the leading independent healthcare ratings organization. The HealthGrades Seventh Annual Women's Health in American Hospitals study also identified hospitals in the top 5% in women's care through an analysis of nearly 7 million hospitalization records from all of the nation's nearly 5,000 nonfederal hospitals.
Compared to men, women had a higher risk of mortality in three cardiovascular procedures: valve-replacement surgery (52.8% higher risk), coronary bypass surgery (36.6%), and coronary interventional procedures (19.5%). Women also had a 5.8% higher risk of dying after a stroke. However, women had a better chance of surviving hospitalization than men for the following procedures and treatments: chronic obstructive pulmonary disease (16.4% lower risk), heart failure (12.8%), pneumonia (10.6%), and heart attack (2.4%).
"The finding that women's outcomes vary so dramatically from men's is surprising not in its result, as this disparity has been documented before, especially in cardiovascular care, but in its magnitude," said Rick May, MD, a vice president with HealthGrades and an author of the study. "The differences in many areas are huge. Fortunately, women now can find this information and have access to great tools, available on HealthGrades.com, to help them find those hospitals that have the best track records of providing high-quality care to women."
Women's patient outcomes in U.S. hospitals not only varied when compared to men's, but also varied widely among hospitals. In the study, HealthGrades analyzed patient outcomes for women, age 65 or older, at all of the nation's nearly 5,000 nonfederal hospitals and identified those hospitals that are in the top 5% in the nation. These top-performing hospitals had mortality rates for women that were 40.5% lower than the category of poorest performing hospitals, and complication rates for women that were 19.1% lower than the poorest performers. In addition, top-performing hospitals improved their mortality rates over the three-year period studied at a faster rate when compared to all other hospitals.
2010/2011 HealthGrades Women's Health Excellence Award
Hospitals with women's patient outcomes in the top 5% are identified as recipients of the 2010/2011 HealthGrades Women's Health Excellence Award™. The data suggests that if all hospitals nationwide performed at the level of the Award recipient hospitals, a total of 16,863 women could have potentially survived their hospitalization and 4,735 women could have potentially avoided a major in-hospital complication. Of the 16,863 potentially preventable deaths, 80.7% were associated with just four diagnoses: pneumonia, heart failure, stroke, and heart attack.
Hospitals receiving the award not only had better patient outcomes, but were improving them at a faster rate. Improvement in mortality and morbidity for hospitals in the top 5% over the three years studied was 14.7% compared with 12.3% for all other hospitals.
Thirty states had at least one recipient of the 2010/2011 HealthGrades Women's Health Excellence Award™. Fifty-one percent of the hospitals in the top 5% were in the following six states: Florida (20), Ohio (15), Texas (14), Illinois (13), Pennsylvania (12) and California (11).
This year, 166 hospitals were recognized with this distinction. The full list of recipients can be found at http://www.healthgrades.com.
Methodology
The annual HealthGrades study analyzed nearly 7 million hospitalizations using Medicare data from all 50 states from 2006 through 2008. Women's Health outcomes were separated into three categories:
1.Women's Medicine (heart attack, congestive heart failure, pneumonia, chronic obstructive pulmonary disease, and stroke)
2.Women's Cardiovascular Procedures (coronary bypass surgery, peripheral vascular bypass, coronary interventional procedures, resection/replacement of abdominal aorta, carotid surgery, and valve replacement); and
3.Women's Bone & Joint Health (total knee and total hip replacement surgeries, spinal surgeries, and hip fracture repair).
Eligible hospitals must: 1) meet volume requirements in stroke and either coronary bypass or valve replacements; 2) meet the volume requirements in at least six additional cohorts of the 16 evaluated; and 3) have transferred out less than 10% of stroke patients. Volume requirements are a minimum of 30 female discharges over the three years, with at least five in the most recent year for the cohort.
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