Hospital quality "needs significant improvement" and "waste remains rampant," according to the latest Leapfrog hospital survey, released Tuesday.
The study was based on the survey of 1,244 hospitals in 45 states in 2009.
Leapfrog researchers said overall quality remains challenged, with fewer than half of hospitals achieving adequate quality standards.
"There is significant improvement in performance, for which we commend hospitals as well as the hundreds of purchasers using Leapfrog data to improve quality of care for employees," said Leapfrog CEO Leah Binder. "Still, at most, half of hospitals ever achieve acceptable standards for mortality, and that's very concerning."
The study found that 53 percent of hospitals surveyed met Leapfrog's quality standard for heart bypass surgery, compared to 43 percent in 2008, while 44 percent of hospitals met Leapfrog's quality standard for heart angioplasty, up from 35 percent in 2008.
In 2009, there was a 56 percent difference between how the highest and lowest performing hospitals used resources for heart bypass surgery. For heart angioplasty, there was a 79 percent difference between the highest and lowest performers.
To gauge waste, researchers used Leapfrog's resource use measure, based on risk-adjusted mean length of stay tempered by readmission rates. Length of stay is a strong determinant of cost, researchers said.
"The variations in resource use among hospitals performing the same type of surgery highlight the opportunities that exist for significantly cutting the costs of care," Binder said. "Employers and other large purchasers of care need to be assertive in demanding hospitals reduce this waste and improve their Leapfrog performance."
"Overall, where purchasers are active using Leapfrog data, we see real change," she said.
In 2009, less than 50 percent of hospitals met Leapfrog's outcome, volume and process standards for six high-risk procedures and conditions. Research suggests that following nationally endorsed and evidence-based guidelines for these procedures and conditions saves lives, according to Binder.
The annual Leapfrog Hospital Survey is used by many in the industry for comparing hospitals' performance on safety, quality and efficiency.
Leapfrog uses a panel of experts to select measures that are evidence-based in peer-reviewed literature and have the most dramatic impact on patient outcomes and cost-effectiveness, Binder said.