HealthGrades has released The Twelfth Annual HealthGrades Hospital Quality in America Study which examined nearly 40 million Medicare hospitalization records for the years 2006, 2007 and 2008. The study looks at trends in mortality and complication rates and also provides the foundation for HealthGrades’ quality ratings of procedures and diagnoses at each individual hospital.
The largest annual study of patient outcomes at each of the nation’s 5,000 nonfederal hospitals found a wide gap in quality between the nation’s best hospitals and all others. According to the study, patients at highly rated hospitals have a 52% lower chance of dying compared with the U.S. hospital average, a quality chasm that has persisted for the last decade even as mortality rates, in general, have declined.
The study also found the following:
MORTALITY
- Overall, inhospital, risk-adjusted mortality at the nation’s hospitals improved, on average, 10.99% from 2006 through 2008.
- Across all 17 procedures and diagnoses in which mortality was studied, there was an approximate 71.64% lower chance of dying in a 5-star rated hospital compared to a 1-star rated hospital.
- Across all 17 procedures and diagnoses studied, there was an approximate 51.53% lower chance of dying in a 5-star rated hospital compared to the national average.
- If all hospitals performed at the level of a 5-star rated hospital across the 17 procedures and diagnoses studied, 224,537 Medicare lives could potentially have been saved from 2006 through 2008.
- Approximately 57% (127,488) of the potentially preventable deaths were associated with four diagnoses: sepsis (44,622); pneumonia (29,251); heart failure (26,374) and respiratory failure (27,241).
- Over the last three studies, Ohio and Florida consistently have had the greatest percentage of hospitals in the top 15% for risk-adjusted mortality.
COMPLICATIONS
- Across all orthopedic procedures in which complications were studied, there was a 79.69% lower chance of experiencing one or more inhospital complications in a 5-star rated hospital compared to a 1-star rated hospital.
- Across all orthopedic procedures studied, there was a 61.22% lower chance of experiencing one or more inhospital complications 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, 110,687 orthopedic inhospital complications may have been avoided among Medicare patients over the three years studied.
STROKE
- Joint Commission stroke-certified hospitals were almost twice as likely to attain a HealthGrades’ 5-star rating in stroke (30.1% of certified hospitals were 5-star versus 15.7% of non-certified hospitals), and fewer of the stroke-certified hospitals fell into HealthGrades’ 1-star category (12.3% versus 19.6%).
- Joint Commission stroke-certified hospitals have an 8.06% lower risk-adjusted mortality rate compared to hospitals that were not stroke-certified.
For this study, HealthGrades rated each of the nation’s 5,000 nonfederal hospitals in nearly 30 procedures and diagnoses. The ratings are objective, created from data provided by the Centers for Medicare and Medicaid Services. HealthGrades’ hospital ratings are independently created; no hospital can opt-in or opt-out of being rated. No hospital pays to be rated. Each hospital receives a 1-, 3-, or 5-star rating for each procedure or diagnosis, reflecting the mortality or complication rates at that hospital. Mortality and complication rates are risk-adjusted, which takes into account differing levels of severity of patient illness at different hospitals and allows for hospitals to be compared on equal footing.