Resource Library

October 20, 2010

The Thirteenth Annual HealthGrades Hospital Quality in America Study
Author: Kristin Reed, M.P.H.; Co-author: Rick May, M.D.
Major Contributors: Carol Nicholas, M.S.T.C., writing, editing and publishing;
Harold Taylor, Ph.D. and Alex Brown, statistical analysis

See full study (PDF).

Summary of Findings

Since 1998, HealthGrades has studied and measured the quality of care at the nation’s 5,000 hospitals and published the results of its annual research on the Web to assist consumers in choosing a hospital. In this report, HealthGrades examines risk-adjusted mortality and complication rates among the nation’s hospitals, assesses the differences between best-performing and worst-performing hospitals, and evaluates the performance of individual states across 14 service areas.

In this year’s study, HealthGrades analyzed approximately 40 million Medicare discharges from almost every U.S. hospital from 2007 through 2009. We also expanded our analysis to evaluate the impact of inhospital performance on all cause mortality at 30 days and 180 days following hospitalization. Individual hospital quality results from this study are available at www.healthgrades.com.

For patient tips on getting the most out of a hospitalization see Patient Tips: Get the Best Hospital Care.

• Hospital unadjusted mortality rates in the United States have improved, on average, 7.98% from 2007 through 2009 across 17 diagnoses and procedures.
• The highest actual mortality rates were among sepsis, respiratory failure, and gastrointestinal surgeries and procedures.
• The most improvement in unadjusted mortality was seen in chronic obstructive pulmonary disease (18.73%), bowel obstruction (14.72%), heart attack (13.68%), and stroke (13.50%).

While the nation’s hospitals are improving overall, the gap between the best and worst hospitals continues to be substantial. The best-performing hospitals have lower mortality rates despite having higher acuity patients. Furthermore, the quality of the inpatient care (as measured by inhospital mortality rates) was directly correlated with both 30-day and 180-day mortality rates from all causes. This means that patients treated at 5-star hospitals are more likely to be alive six months following their hospitalization.

• 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.
• A typical patient would have a 72.47% lower risk of dying in a 5-star rated hospital compared to a 1-star rated hospital, and a 53.36% lower risk of dying by going to 5-star rated hospital compared to the U.S. hospital average.

If all hospitals performed at the level of a 5-star rated hospital, 232,442 Medicare lives could potentially have been saved from 2007 through 2009.

• Approximately 55.91% (129,949) of the potentially preventable deaths were associated with just four diagnoses:
  1)  Sepsis (48,809)
  2)  Pneumonia (29,017)
  3)  Respiratory Failure (26,361)
  4)  Heart Failure (25,762)

On average, one in nine patients developed a hospital-acquired complication, across the nine procedures evaluated for inhospital complications, from 2007 to 2009.

• On average, a typical patient would have an 80.40% lower risk of developing one or more inhospital complications by going to a 5-star rated hospital compared to a 1-star hospital and a 63.64% lower risk of developing one or more inhospital complications by going to a 5-star hospital compared to the U.S. hospital average.
• If all hospitals performed at the level of a 5-star rated hospital across the nine complication-based procedures studied, 185,875 Medicare inhospital complications may have been avoided.

See Overall Combined Mortality Ratings