HealthGrades: 52% less chance of dying at top-rated hospitals

Patients at highly rated hospitals have a 52 percent 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 have generally declined, according to the annual study of patient outcomes at 5,000 U.S. nonfederal hospitals published Tuesday by HealthGrades.

The 12th annual HealthGrades Hospital Quality in America Study examined nearly 40 million Medicare hospitalization records from 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 new 2010 ratings for individual hospitals are available at the HealthGrades' Web site and are designed to help patients compare the quality of care at local hospitals for 28 different procedures and treatments.

Concerning mortality statistics, the study found the following:

• Overall, in-hospital, risk-adjusted mortality at U.S. hospitals improved, on average, 10.99 percent from 2006 through 2008.
• Across all 17 procedures and diagnoses in which mortality was studied, there was an approximate 71.64 percent lower chance of dying in a five-star rated hospital compared with a one-star rated hospital.
• Across all 17 procedures and diagnoses studied, there was an approximate 51.53 percent lower chance of dying in a five-star rated hospital compared with the national average.
• If all hospitals performed at the level of a five-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 percent of the potentially preventable deaths were associated with just 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 percent for risk-adjusted mortality.

Concerning complication statistics, the study found the following:

• Across all procedures in which complications were studied, there was a 79.69 percent lower chance of experiencing one or more in-hospital complications in a five-star rated hospital compared with a one-star rated hospital.
• Across all procedures studied, there was a 61.22 percent lower chance of experiencing one or more in-hospital complications in a five-star rated hospital compared with the U.S. hospital average.
• If all hospitals performed at the level of a five-star rated hospital, 110,687 orthopedic in-hospital complications may have been avoided among Medicare patients over the three years studied.

Specifically for stroke, the authors reported that the Joint Commission stroke-certified hospitals were almost twice as likely to attain five-star status in stroke (30.1 percent of certified hospitals were five-star versus 15.7 percent of non-certified), and fewer of the stroke-certified hospitals fell into the one-star category (12.3 vs. 19.6 percent). Also, Joint Commission stroke-certified hospitals have an 8.06 percent lower risk-adjusted mortality rate compared with hospitals that were not stroke-certified.

"The fact is, patients are twice as likely to die at low-rated hospitals than at highly-rated hospitals for the same diagnoses and procedures," said study author Rick May, MD. "With Washington focused on rewarding high-quality hospitals and empowering patients to make more informed healthcare choices, this information comes at a turning point in the healthcare debate."