Hospital choice for emergency care can improve survival by 40%

Robin Wulffson MD's picture
emergency department, survival, HealthGrades, hospital rating
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DENVER, CO – When a medical emergency occurs and an ambulance appears at your location, you may have the opportunity to select your preferred hospital. According to a new report, your choice of hospitals may determine whether you live or die.

HealthGrades Emergency Medicine in American Hospitals, which was released on February 21, found significant differences in the risk adjusted mortality rates for patients admitted to hospital emergency departments. The rating agency is reportedly the leading provider of information to assist consumers make an informed decision regarding a physician or hospital. The information is sorted both by hospital and market area.

To compile the findings, Healthgrades reviewed the medical records of more than seven million Medicare patient records presenting at emergency departments from 2008 to 2010. Included in the survey were the following diagnoses: Bowel Obstruction; Chronic Obstructive Pulmonary Disease (COPD); Diabetic Acidosis and Coma; Gastrointestinal Bleed; Heart Attack; Heart Failure; Pancreatitis; Pneumonia; Pulmonary Embolism; Respiratory Failure; Sepsis (infection); and Stroke. The report included only those patients admitted to the hospital from the emergency room for further medical treatment; thus, their analysis was limited to patients who received the full continuum of care.

Of all analyzed hospitals, 263 that performed in the top five percent in the nation were designated as Emergency Medicine Excellence Award™ hospitals. A full listing of these hospitals, by city, can be found online at HealthGrades.com. “It is imperative that anyone experiencing a medical emergency go directly to the closest hospital, especially in the event of a heart attack or stroke,” noted Dr. Arshad Rahim, report author and Director of Accelerated Clinical Excellence at HealthGrades. He added, “That said, our study findings show the care you receive once admitted to the hospital can also make the difference between life and death. We encourage all patients to educate themselves about the quality of emergency medical providers in their area and to choose a top performing hospital whenever there is a choice.”

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Other significant findings by HealthGrades include:

  • From 2008 to 2010, emergency room admissions for heart attack were
  • down 1.7% and stroke admissions were up 2.2% among Medicare recipients.
  • For the group of patients studied, Emergency Medicine Excellence hospitals had, on average,
  • 41.52% lower risk-adjusted mortality than all other hospitals across the 12 diagnoses studied.
  • If all hospitals performed at the level of the Emergency Medicine Excellence hospitals from 2008 through 2010, an additional 170,856 people could have potentially survived their emergency hospitalization.
  • More than 61% of hospital admissions among seniors begin in the emergency
  • department, higher than any other age group.

Approximately 36% (94 out of 263) of the Emergency Medicine Excellence hospitals are located in eight dominant market areas (DMAs): Chicago, IL (18); Los Angeles, CA (15); Baltimore, MD (12); Cleveland, OH (12); Phoenix - Prescott, AZ (12); St. Louis, MO (9); Cincinnati, OH (8); and Detroit, MI (8).

The top 10 cities with the lowest risk-adjusted mortality for patients admitted through the emergency department are: Milwaukee, WI; Phoenix - Prescott, AZ; Cincinnati, OH; West Palm Beach, FL; Baltimore, MD; Traverse City, MI; Dayton, OH; Cleveland, OH; Fargo, ND; and Detroit, MI.

To be included in the analysis, hospitals had to meet minimum thresholds in terms of patient volumes, quality ratings, and the range of services provided. The hospital ratings were independently created; no hospital could either opt-in or opt-out of being rated, and no hospital
paid to be rated.

Company Information (from HealthGrades):
HealthGrades, headquartered in Denver, Colorado, is reportedly a leading provider of comprehensive information about physicians and hospitals. More than 200 million consumers use the HealthGrades Websites, including HealthGrades.com and BetterMedicine.com, to research, select, and connect with a physician or hospital, and use its comprehensive information about clinical outcomes, patient satisfaction, patient safety, and health conditions to make more informed healthcare decisions and take action.

References:
Healthgrades
HealthGrades Emergency Medicine in American Hospitals

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