Study: Death rate 70 percent lower at top-rated hospitals

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Patients have a 70 percent lower chance of dying at U.S. top-rated hospitals on average, compared with the lowest-rated hospitals, according to results from the eleventh annual HealthGrades Hospital Quality in America study, issued Tuesday by HealthGrades, an independent healthcare ratings organization.

While overall death rates declined from 2005 to 2007, top-rated hospitals were able to reduce their death rates at a much faster rate than poorly performing hospitals, resulting in large state, regional and hospital-to-hospital variations in the quality of patient care, the study found.

The HealthGrades Hospital Quality in America study, which analyzed 17 procedures and conditions across U.S. hospitals, found that if all hospitals performed at the level of five-star rated hospitals, 237,420 Medicare deaths could potentially have been prevented over the three years studied. More than half of those deaths were associated with four conditions: sepsis, pneumonia, heart failure and respiratory failure.

The HealthGrades study of patient outcomes at the nation's approximately 5,000 hospitals is an annual study, analyzing more than 41 million Medicare hospitalization records from 2005 to 2007. The study examines procedures and conditions ranging from heart valve-replacement surgery to heart attack to pneumonia.

The study also found that the nation's inhospital risk-adjusted mortality rate improved, on average, 14.17 percent from 2005 to 2007, but the degree of improvement varied widely by procedure and diagnosis studied (range: 6.30 to 20.94 percent). Five star-rated hospitals' mortality rates continue to improve at a faster rate (13.18 percent) than one- or three-star hospitals (12.30 and 13.14 percent, respectively).

Additionally, 54 percent of the potentially preventable deaths were associated with just four diagnoses: Sepsis, heart failure, pneumonia and respiratory failure. Variation in mortality exists not only at the national level, but also at the state and regional levels. The greatest quality differences between states occurred in hospital death rates for heart failure, pulmonary, stroke and cardiac surgery.

The region with the lowest overall mortality rates was the East North Central region, while the East South Central region had the highest mortality rates. The East North Central region had the highest percentage of best-performing hospitals at 26 percent. Less than seven percent of hospitals within New England were top-performing hospitals.

In the study's analysis of hospital death rates, the following 17 procedures and conditions were analyzed: bowel obstruction, chronic obstructive pulmonary disease, coronary bypass surgery, coronary interventional procedures, diabetic acidosis and coma, gastrointestinal bleed, gastrointestinal surgeries and procedures, MI, heart failure, pancreatitis, pneumonia, pulmonary embolism, resection/replacement of the abdominal aorta, respiratory failure, sepsis, stroke and valve replacement surgery.

Based on the study, HealthGrades has published its 2009 quality ratings for U.S. nonfederal hospitals at