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Medicare's Hospital Ratings System May Be Flawed

Study finds it bears little relation to actual patient outcomes

WEDNESDAY, Dec. 13, 2006 (HealthDay News) -- Medicare's standard hospital-performance measures may not accurately reflect real-life patient outcomes, U.S. researchers report.

They found little difference in death rates for three common conditions -- heart attack, heart failure and pneumonia -- at hospitals with low and high Medicare performance measures. The study, by researchers from the University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center, analyzed ratings for more than 3,600 acute care hospitals in the United States.

The study included Centers for Medicare and Medicaid Services' (CMS) data on hospital care between Jan. 1, 2004, and Dec. 31, 2004. The researchers found that, across all heart attack performance measures, the absolute reduction in risk-adjusted death rates between hospitals in the 25th percentile and those in the 75th percentile was 0.005 for inpatient death, 0.006 for 30-day death, and 0.012 for death at one year.

For heart-failure performance measures, the absolute reduction in deaths was very small, ranging from 0.001 for inpatient death to 0.002 for death at one year, and for pneumonia it ranged from 0.001 for 30-day death to 0.005 for inpatient death.

The findings are published in the Dec. 13 issue of the Journal of the American Medical Association.

"Our study suggests that in the case of hospital performance, the CMS's current set of performance measures are not tightly linked to patient outcomes," the study authors wrote.

"These findings should not undermine current efforts to improve health care quality through performance measurement and reporting. However, attention should be focused on finding measures of health care quality that are more tightly linked to patient outcomes. Only then will performance measurement live up to expectations for improving health care," they concluded.

More information

Here's where you can find CMS's Hospital Compare.

SOURCE: American Medical Association, news release, Dec. 12, 2006
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