Patients treated at five-star-rated hospitals had a 72 percent lower risk of dying compared to those at one-star-rated hospitals, according to a study by the healthcare ratings organization HealthGrades.
This gap has held steady over the past years, even as overall mortality rates have improved.
“We are encouraged by the steady improvement in mortality rates among America’s hospitals, but there's an unacceptably wide gap that has persisted between the top-performing hospitals and all others in terms of patient outcomes,” said Rick May, MD, an author of the study and a vice president with HealthGrades.
“Thirteenth Annual HealthGrades Hospital Quality in America” analyzed objective mortality and complication rates at the nation's 5,000 non-federal hospitals using 40 million hospitalization records obtained from the Centers for Medicare and Medicaid Services.
The study, the largest of its kind, identified national and state-level trends in hospital care quality and established quality ratings for each hospital across 26 different procedures and diagnoses.
HealthGrades found that hospital mortality rates, on average, have declined by 7.98 percent over the three-year period studied, from 2007 to 2009. Of the 17 mortality-based diagnoses and procedures analyzed, only two – gastrointestinal surgeries and coronary intervention procedures – bucked the overall trend with increasing mortality rates.
HealthGrades rated individual hospitals with one, three or five stars in 26 procedures and diagnoses, from bypass surgery to total knee replacements. A typical patient would have a 72.47 percent lower risk of dying in a five-star-rated hospital compared to a one-star-rated hospital and a 53.36 percent lower risk of dying by going to five-star-rated hospital compared to the U.S. hospital average.
If all hospitals performed at the level of a five-star-rated hospital, 232,442 Medicare lives could potentially have been saved from 2007 through 2009.
“For hospital leaders as well as potential patients, it is essential that they understand – and act upon – these findings,” May said.
Another recent hospital quality care study, by The Joint Commission, suggests that accredited U.S. hospitals are providing higher-quality, evidence-based care for heart attacks, pneumonia, surgical care and children’s asthma.
The data, drawn from more than 3,000 accredited hospitals, shows significant progress in consistently using evidence-based treatments. In 2002, hospitals achieved 81.8 percent composite performance on 957,000 opportunities to perform care processes related to accountability measures, while in 2009, hospitals achieved 95.4 percent composite performance on 12.5 million opportunities – an improvement of 13.6 percent.
“It is very encouraging that this year’s report shows high rates of performance on these critical process measures and high levels of consistent excellence among hospitals on many measures,” said Mark R. Chassin, MD, president of The Joint Commission. “Hospitals devote enormous resources and energy to using these performance measures to drive improvement in their clinical processes.”
The Joint Commission intends to include specific expectations for performance on accountability measures in hospital accreditation standards by 2012.