'America's Best Hospitals' Tops for Heart Attack Survival

But some centers that don't make the list offer fine care, study finds

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TUESDAY, July 10, 2007 (HealthDay News) -- Heart attack patients are more likely to survive the month if they are admitted to a hospital ranked as "America's Best" by U.S. News & World Report, a new study found.

However, the study authors cautioned that the rankings may not necessarily reflect which hospitals provide the best quality care.

Dr. Oliver Wang of Yale University School of Medicine and his colleagues analyzed 30-day death rates among 13,662 patients admitted to 50 hospitals ranked on the U.S. News list as the best in "heart and heart surgery." They also analyzed death rates among 254,907 patients admitted to 3,813 unranked hospitals in 2003. Then the researchers examined the hospitals' standardized mortality ratios, where a ratio greater than one indicates that the hospital had more deaths than expected. A ratio of less than one indicates fewer deaths than expected.

Writing in the July 9 Archives of Internal Medicine, the researchers noted that 30-day death rates for heart patients were lower, on average, in ranked hospitals than in non-ranked hospitals. When the hospitals were divided into four groups based on these rates, 35 ranked hospitals were in the group with the fewest deaths, 11 were in the middle two groups and four were in the worst-performing group.

However, the researchers noted that 11 of the ranked hospitals and 28 of the non-ranked hospitals had lower-than-expected death rates in the heart disease category.

Based strictly on the numbers, the researchers expressed concern that not all ranked hospitals have the best mortality rates and outcomes, and that some top quality hospitals were not ranked.

"The U.S. News & World Report ranking, which includes many of the nation's most prestigious hospitals, did identify a group of hospitals that was much more likely than non-ranked hospitals to have superb performance on 30-day mortality after acute myocardial infarction," the study authors wrote in a prepared statement.

"However, our study also revealed that not all ranked hospitals had outstanding performance, and that many non-ranked hospitals performed well. Consequently, although the U.S. News & World Report rankings provide some guidance about the performance on outcomes, they fall short of identifying all the top hospitals with respect to 30-day survival after admission for acute myocardial infarction and include a few hospitals that are actually in the lowest quartile of performance."

More information

To learn about heart disease, visit the American Heart Association.

SOURCE: Archives of Internal Medicine, news release, July 9, 2007

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