HealthGrades 2007 Hospital-Quality Study and Ratings: Chasm Widens

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US Hospital Ratings

The most comprehensive annual study of hospital quality in America examines 41 million hospitalization records at 5,000 hospitals over three years; shows mortality rates decline.

The largest annual study of hospital quality in America, issued today by HealthGrades, finds a typical patient, on average, has a 69 percent lower chance of dying at the nation's 5-star rated hospitals compared with the 1-star hospitals. This "quality chasm" between the best and poorest-performing hospitals has grown by approximately 5 percent since last year's study, even as overall mortality rates have improved by nearly 8 percent.

The ninth annual HealthGrades Hospital Quality in America Study analyzes 40.6 million Medicare hospitalization records, from the years 2003 through 2005, to rate the quality of care at each of the nation's more than 5,000 nonfederal hospitals. To help consumers compare the quality of local hospitals, HealthGrades posts its ratings free of charge on its consumer Web site, HealthGrades.com, and in its suite of decision-support tools that major employers and health plans offer as a benefit to employees and plan members.

"This year's study finds that mortality rates among Medicare patients continues to decline, however the differences in patient outcomes between 5-star and 1-star hospitals remains large and is getting larger, a concerning finding," said Samantha Collier, MD, the author of the study and the vice president of medical affairs at HealthGrades, the leading independent healthcare ratings organization. "But these are more than numbers. According to the study, more than 300,000 Medicare lives could have been saved during the three years studied if all hospitals performed at the level of hospitals rated with 5 stars."

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For example, the study shows that a typical patient having coronary bypass surgery has a 72.9 percent lower risk of mortality, on average, if they have the procedure at a 5-star rated hospital compared with a 1-star rated hospital. If all Medicare coronary bypass surgery patients from 2003 to 2005 went to 5-star hospitals, 5,308 lives could have been saved.

The annual HealthGrades study rates every nonfederal hospital with a 1-, 3- or 5-star rating indicating poor, average or excellent outcomes in each of 28 medical categories. Taken together, the individual hospital ratings produce the following findings:

  • The nation's in-hospital risk-adjusted mortality rate improved, on average, 7.89 percent from 2003 to 2005. But the degree of improvement varied widely by procedure and diagnosis studied.

  • Five-star rated hospitals had significantly lower risk-adjusted mortality rates across all three years studied and improved, over the years 2003 to 2005, 19 percent more than the U.S. hospital average and 57 percent more than 1-star rated hospitals.

  • A typical patient would have, on average, a 69 percent lower chance of dying in a 5-star rated hospital compared to a 1-star rated hospital, and a 49 percent lower chance of dying in a 5-star rated hospital compared to the U.S. hospital average.

  • If all hospitals performed at the level of a 5-star rated hospital across 18 of the procedures and diagnoses studied, 302,403 Medicare lives could have potentially been saved from 2003 through 2005. Fifty percent of the potentially preventable deaths were associated with just four diagnoses: Heart Failure, Community Acquired Pneumonia, Sepsis and Respiratory Failure.

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