Hospital Ratings Don't Fully Reflect Patient Outcomes

Specific interventions help, but don't explain variations in heart attack survival, researchers say

WEDNESDAY, July 5, 2006 (HealthDay News) -- Standard hospital quality assessments don't always reflect the outcomes of patients treated at particular centers, according to a U.S. study that looked at death rates for heart attack patients.

Researchers at Yale University School of Medicine analyzed 2002-2003 data from 962 hospitals on heart attack patients who were age 66 or older. They also looked at publicly reported hospital performance data from the Centers for Medicare & Medicaid Services.

There was significant correlation between some hospital measures and risk-standardized, 30-day death rates, the researchers found. However, these measures accounted for only 6 percent of hospital-level variation in 30-day death rates for heart attack patients.

The study identified moderately strong correlations between use of heart drugs such as beta-blockers at both hospital admission and discharge, aspirin use at admission and discharge, and angiotensin-converting enzyme (ACE) inhibitor use.

It also found weaker, but statistically significant, correlations between these medication measures and smoking cessation counseling and time to reperfusion therapy measures.

"This finding suggests that a hospital's short-term mortality rates after [heart attack] cannot be reliably inferred from performance on the publicly reported process measures," the Yale team concluded in a prepared statement.

Their report was published in the July 5 issue of the Journal of the American Medical Association.

More information

The American Heart Association has more about heart attack treatments.

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