New Research Finds Significant Number of Americans Not Getting Care at Right Hospitals

Oct 20, 2015

Healthgrades Report Emphasizes Importance of Choosing the Right Doctor and Hospital

Based on Outcomes and Experience

Denver, CO (October 20, 2015) – One out of every six patients in the U.S. received care in a hospital rated 1-star, 1 according to new research released by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. Had those patients researched local doctors and hospitals to identify and select a physician practicing in a 5-star hospital for their specific procedure or condition, they would have faced a 71 percent lower risk of dying or a 65 percent lower risk of experiencing complications during their hospital stay. If all hospitals performed similarly to hospitals receiving 5-stars, 222,392 lives would have potentially been saved. 2

Healthgrades 2016 Report to the Nation, which compares the patient outcomes resulting from care in hospitals rated 1-star (those with the higher risk adjusted complication rates and mortality rates) against 3-and 5-star hospitals in regions throughout the country, concludes that significant variation in health outcomes exists between hospitals throughout the U.S.

As consumers take on greater responsibility for their medical costs due to rising premiums and the increase in high-deductible plans, it is increasingly important that they do their homework and select the right doctor and hospital for their specific needs. Healthgrades provides transparent access to accurate, objective data so that consumers and physicians can make more informed decisions when it comes to finding and connecting with the right physician.

According to Healthgrades, when presented with objective information – including physician experience, patient satisfaction and hospital outcomes – 85 percent 3 of patients would select a different physician than they did before doing their homework. Doing research to find the right physician, including understanding the quality of the hospitals where physicians practice, is essential to getting the right care.

“Because narrow networks are limiting many patients’ access to certain physicians and hospitals, it is more important than ever that consumers recognize the symbiotic relationship between doctor and hospital, and do their research to make what may be a lifesaving decision about the care they receive,” said Evan Marks, Chief Strategy Officer at Healthgrades. “Consumers need to trust that the information they’re using to inform their decisions is comprehensive, accurate and – most importantly – transparent. Transparency is crucial to fostering accountability at all levels of the healthcare industry, ultimately empowering consumers to use data to improve their chances of experiencing the best outcomes possible.”

Healthgrades’ findings also reflect startling disparities at the local level. According to the report, hospitals within close proximity from each other can have significant differences in complication and mortality rates for the same condition or procedure. For example, in Denver, CO, when comparing patient clinical outcomes among hospitals for hip replacement surgery, complication rates varied significantly across facilities, from 3.9 percent to 13.6 percent.

Additionally, few hospitals can claim superior performance across all conditions and procedures; While hospitals may receive a 5-star rating for one condition or procedure, they may not demonstrate superior performance across all areas evaluated. In the Chicago region, of 14 hospitals that received a 5-star rating for treating heart attacks, eight received a 1-star rating when evaluated for total knee replacement surgeries.

The quantity of hospitals in a region also does not directly correlate with the quality of care available to consumers. While most major metro areas may be home to more than 30 hospitals, only a small percentage may provide better than expected outcomes for the specific procedure a patient needs. For example:

  • In Chicago, of 46 hospitals that perform coronary artery bypass graft (CABG) surgery, only two have a 5-star rating for this procedure.

  • In Houston, of 38 hospitals that treat chronic obstructive pulmonary disease (COPD), or emphysema, only one has a 5-star rating for this condition.

  • In the greater Los Angeles area, of 41 hospitals that perform coronary artery bypass graft (CABG) surgery, only six have 5-star rating for this procedure.

  • In Philadelphia, of 34 hospitals that treat heart attack, only four have a 5-star rating for this condition.

  • In the greater New York area (including northern New Jersey), of 102 hospitals that perform colorectal surgeries, only two have a 5-star rating for these procedures.

“The hospital a patient selects for his or her care can significantly impact the chances of experiencing complications, or even mortality, for certain conditions or procedures,” said Archelle Georgiou, M.D., Strategic Advisor, Healthgrades. “With quality of life on the line, consumers must be proactive in researching their options and leveraging all the data at their fingertips to make the best decision possible.”
Healthgrades 2016 Report to the Nation not only includes more specific comparative data about hospitals throughout the U.S., but also provides consumers with guidance on ways to make the best choices to mitigate the risks of having negative outcomes. In addition, Healthgrades has created  regional pocket guides – for 50 key markets in the U.S. – highlighting the top performing hospitals for specific conditions and procedures. These pocket guides complement the in-depth information available at Healthgrades.com and provide consumers with an easy to access resource to choose the right hospital for the right care.

Healthgrades is the only site that provides consumers with information on more than 12,000 diseases, conditions and procedures and 1,100 specialties, based on data from more than 90% of inpatient hospital admissions. Access to this data empowers consumers to make informed healthcare decisions and select the right doctor and right hospital for their personal and specific care needs.

About the Report

Unlike other organizations evaluating hospital quality, Healthgrades provides objective measures rooted solely in the domains of clinical science and statistical analysis, leaving perception and reputation out of the equation. Every year, Healthgrades analyzes three years of Medicare Provider Analysis and Review (MedPAR) data to produce a detailed report on complication and mortality rates in America’s hospitals. Healthgrades findings empower consumers to evaluate and compare hospital performance.

For the  2016 report, Healthgrades analyzed approximately 45 million Medicare patient records for nearly 4,500 short-term, acute care hospitals nationwide, assessing hospital performance relative to common in-hospital conditions and procedures for the Medicare population from 2012 through 2014 and one condition based on All-payer state data from 2011 through 2013.

Healthgrades models adjust for risk factors that influence patient outcomes. These factors may include age, gender, specific procedure performed, and co-morbid conditions, such as high blood pressure and diabetes. The outcomes reflect clinically-based measures, including in-hospital complications or in-hospital and 30-day post-admission mortality. Healthgrades detailed and transparent methodologies can be found here  http://www.healthgrades.com/quality/methodology-mortality-and-complications-outcomes.

About Healthgrades

Healthgrades, headquartered in Denver, Colorado, is the leading online resource for comprehensive information about physicians and hospitals. Today, more than one million people a day use the Healthgrades websites to search, compare and connect with hospitals and physicians based on the most important measures when selecting a healthcare provider: experience, hospital quality and patient satisfaction. For more information about Healthgrades, visit  http://www.healthgrades.com  or download the  Healthgrades iPhone app.

1Statistically significantly worse than expected mortality or complications outcomes across 10 conditions and procedures studied during the 2012-2014 study period.
2Statistics are based on Healthgrades analysis of MedPAR data for years 2012 through 2014, if all hospitals as a group, performed similarly to hospitals receiving 5-stars as a group across all rated cohorts.
32015 Stax Research Study for Healthgrades on Consumer Behavior When Choosing a Doctor.

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