Older patients were 69 percent less likely to die last year at hundreds of the best U.S. hospitals than at hundreds of the worst, a study says.
While hospitals reduced mortality by 7.9 percent in the three years through 2005, some had larger reductions, and the gap between worst and best widened about 5 percent last year alone, Golden, Colorado-based Health Grades Inc., said today. The research by the health-industry ratings company looked at patients age 65 and older.
“Although everybody’s improving, the best are getting better and the bottom isn’t improving as fast,” Samantha Collier, the study’s author, said in an Oct. 12 telephone interview.
Collier, vice president of medical affairs at Health Grades, said some of the best performers among the 5,170 hospitals examined have reduced deaths during common procedures by providing more information to patients and more performance-based pay to executives. The findings, which are published on line, are designed help patients choose the best facility for elective treatments, she said.
28 Procedures Health Grades computed overall hospital performance after looking at the top and bottom 10 percent to 15 percent of facilities, ranked by mortality rates, for 28 types of medical treatments. Some hospitals vary in standing for different procedures or don’t have enough cases to be included in each category.
The report doesn’t name any hospitals.
Some of the 28 diagnoses examined, including blood clots and pancreas inflammation, were associated with more than an eightfold higher risk of death at the bottom-tier hospitals, according to the study.
Louis Evan Teichholz, chief of cardiology at Hackensack University Medical Center in New Jersey, said setting up policies and reminders about how each type of case should be handled can help hospitals reduce the risk of patient death. The medical center, which is situated about 18 miles from New York City, was ranked in the top 5 percent of hospitals in a separate Health Grades study earlier this year.
“You don’t get to be the better hospital because you’re just really worried about the numbers,” Teichholz said in an Oct. 13 telephone interview. “The concept is to put the patient at the center. If you do all the right things, I believe the numbers will follow.” Reducing the number of complications, such as infections, will also help hospitals lower health-care costs, he said.
More than 302,000 lives could have been saved from 2003 through 2005 if all hospitals had performed as well as the top ones, Collier said. Heart failure, pneumonia, respiratory failure and blood infections accounted for almost half of preventable deaths, according to the report.
The study, the ninth in an annual series, reviewed 41 million records from the U.S. Medicare health plan in order to rate the quality of care. The growing gap between the best hospitals and others is a recurring theme in Health Grades’ research. In February, the company reported that patients are 27 percent less likely to die at the top 277 U.S. hospitals than at other medical centers.
Previous studies have shown that no specific type of hospital or geographical region has better performance ratings, Collier said. Health Grades is planning a follow-up analysis in the next three to four months to identify specific features that the best, and worst, facilities have in common, she said.
Health Grades provides some free reports to guide consumers and also sells rating information on hospitals, nursing homes and doctors to employers, consultants and other customers.
