Better Hospital Care Means More Lives Saved

Top-ranked U.S. centers did better against heart attack, pneumonia, study found

TUESDAY, July 17, 2007 (HealthDay News) -- American patients are less likely to die if cared for at hospitals typically ranked high in quality, a new study confirms.

According to the researchers, if the lowest-ranked hospitals had the same death rates as top-ranked hospitals, 2,200 fewer older Americans would die each year from heart attacks, congestive heart failure or pneumonia.

The findings may prompt Americans to dig a bit harder when deciding where they'd like to receive their care. in "Patients still rely on word of mouth, they rely on general reputation," noted Dr. Ashish Jha, an assistant professor of health policy and management at Harvard School of Public Health, in Boston.

"But this study says that there is quality information out there that is really helpful in identifying hospitals where you are going to have better outcomes. I hope consumers will become much more active about picking good providers," he said.

The report is published in the July/August issue of Health Affairs.

Accordng to Jha, "there has been a new effort by Medicare and others to start reporting on quality measures and increasing the transparency of our health care system by having more quality information out there for consumers."

His team wanted to see if these quality measures were reflected in better patient outcomes. "Consumers, at the end of the day, care about outcomes. They care about whether they are going to live or die from their condition when they go to the hospital," Jha said.

In the study, Jha's team used data from the Hospital Quality Alliance, a public-private partnership that includes the Centers for Medicare & Medicaid Services and the American Hospital Association.

They looked at 2004-2005 performance scores from 3,720 U.S. hospitals and found that, compared with hospitals in the lowest quality score, hospitals with top quality scores had almost a 1 percent lower death rate for patients who had a heart attack, 0.4 percent fewer deaths among patients with heart failure, and 0.8 percent few deaths for patients with pneumonia.

In fact, if the lowest-ranked hospitals had the same death rates for these conditions as the top-ranked hospitals, there would be 2,200 fewer patient deaths each year, the researchers concluded.

These findings are really a confirmation of the value of these quality measures for predicting outcomes, Jha said.

One expert believes a hospital's level of care is probably not tied to its treatment of any one condition but instead reflects an institution-wide commitment to quality care.

"One interesting question is whether hospitals that did well meeting one quality indicator were more likely to do a better job meeting other quality indicators," said Dr. John R. Clarke, the clinical director for Patient Safety and Quality Initiatives at the ECRI Institute and a professor of surgery at Drexel University, Philadelphia.

"My instinct is that consistently providing good care is the result of a hospital being well organized, not the result of some diligent [individual] practitioners. This study should convince hospitals to be as concerned about consistently giving good care as they are in getting new, state-of-the art equipment," Clarke said.

More information

The U.S. Department of Health & Human Services offers information about hospital quality.

SOURCES: Ashish Jha, M.D., Ph.D., assistant professor, health policy and management, Harvard School of Public Health, Boston; John R. Clarke, M.D., clinical director, Patient Safety and Quality Initiatives, ECRI Institute, professor of surgery, Drexel University, Philadelphia; July/August 2007, Health Affairs
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