U.S. Top-Rated Hospitals Prove Their Reputation

By Margarita Nahapetyan

The top-rated hospitals of the United Stated have a 27 per cent lower death rate than other hospitals, according to a study by HealthGrades, an independent health care ratings organization. HealthGrades states also that 8 per cent of the patients in the best hospitals are less likely to suffer complications after surgery, on average, than patients in other hospitals.

HealthGrades gave the clinical excellence designation to 277 hospitals nationwide. They were determined by analyzing nearly 41 million Medicare patients, treated at almost 5,000 U.S. non-federal hospitals. The study used data from a government database for the years of 2005 through 2007 and focused on 26 common diagnoses and procedures, including heart failure, heart attack, stroke, pneumonia, angioplasty, gastrointestinal surgeries, coronary artery bypass surgery, sepsis, and a complete hip replacement.

The study found that hospitals ranked in the top 5 per cent nationally lowered their in-hospital death risk rates by an average of 18 per cent as compared to 13 per cent for all other hospitals. Patients treated at these hospitals also had an 8 per cent lowered risk of complications for diagnosis and procedures that include orthopedic and neurosurgery, vascular surgery, prostate surgery and gall bladder surgery.The in-hospital complication rates were also reduced at the top rated hospitals by more than 3.9 per cent compared to about 2.5 per cent for all other hospitals from 2005 to 2007. Dr. Rick May, senior physician consultant and an author of the study, said, "What's very impressive is that when you look at statistics at high-performing hospitals." It's clear that "they don't get [the HealthGrades distinction] by chance. They do it by being extremely focused."

According to HealthGrades Seventh Annual Hospital Quality and Clinical Excellence study, if the quality of care at all hospitals matched that of the top-rated hospitals, 152,666 lives could have been saved, and 11,772 major complications could have been avoided during the three year period of the study."This study echoes others that have found distinct quality gaps between top-performing hospitals and others. Distinguished Hospitals for Clinical Excellence comprise a group of hospitals that excels across the board, not just in one or two specialties, and they should be commended for their relentless commitment to exceptional patient care," said Dr. May in a news release.

The top hospitals came out 37.5 per cent better in COPD, 36.27 per cent in pulmonary embolism, and 35.54 per cent better in pneumonia. Lower complication rates across nine procedures ranged from 1.56 per cent in back and neck surgery to 14.14 per cent in prostatectomy. Following prostatectomy, the biggest differences in risk for complications compared with all hospitals was seen in hip fracture repair - 12.6 per cent, and total hip replacement - 12.54 per cent.

When broken down by state, Minnesota and Maryland had the highest percentage of top-rated hospitals, each with 44 per cent of all eligible hospitals. A leading health care ratings company also ranked Banner Del E. Webb Medical Center in Sun City West, Missouri Baptist Medical Center in St. Louis, The Mayo Clinic Hospital in Phoenix and two Scottsdale Health Care Systems hospitals in Arizona, Central DuPage Hospital, Provena St. Joseph Medical Center, and Advocate Good Samaritan Hospital in California, among the top 5 per cent nationally.

Last week, the Office of Statewide Health Planning & Development, or OSHPD, made available a database online that compares in-patient mortality rate for five different procedures and three conditions including stroke, hip fractures and brain surgery at 384 hospitals in California. According to the study, in 2007, hospitals registered numbers of lethal outcomes that were significantly better than the state average in one category at least, while 94 were much worse in at least one category. For 2006, data showed that 33 hospitals had death rates that were significantly better on at least one indicator, while 98 hospitals rated significantly worse on at least one indicator.

"We have teams of nurses, physicians and others who gather regularly to assess how well we're doing clinically in each of the services we provide," Jeff Nelson, director of public relations said "We evaluate the care we provide from many different angles. Are we keeping patients safe? Are staff members attentive to patients' needs? Are we cognizant of each patient's prescribed diet before we bring in a meal? All of these things and more add up to a positive patient experience and positive clinical outcomes." "Of course, it's always nice to be recognized, but awards like that from HealthGrades are certainly not what drive us to strive for clinical excellence," "The more meaningful reward to us is seeing a patient leave our hospital feeling much better than when they arrived," concluded Nelson.