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Health Areas » Hospital Research » Hospital Quality 2009

Hospital Quality 2009: Hospital Research

HealthGrades Seventh Annual Hospital Quality and Clinical Excellence Study (January 2009)

Executive Summary

Each year HealthGrades independently assesses the quality of care provided at the nation's nearly 5,000 non-federal hospitals across 26 procedures and diagnoses and makes specific hospital ratings available to consumers at www.HealthGrades.com. In this seventh annual study, HealthGrades objectively identifies hospitals that are performing among the best in the nation, designates each of these hospitals as a HealthGrades Distinguished Hospital for Clinical Excellence, and compares them to all other hospitals.

Specifically, HealthGrades examines the differences in risk-adjusted mortality and complications between these top-performing hospitals and the rest of the nation's hospitals. This analysis highlights the vast differences in patient care between these top-performing hospitals and the rest. This study also summarizes the distribution of Distinguished Hospitals for Clinical Excellence by state.

HealthGrades' analysis is based on more than 41 million Medicare hospital discharges for the years 2005, 2006 and 2007. HealthGrades identifies the Distinguished Hospitals for Clinical Excellence based on overall performance of risk-adjusted outcomes associated with 26 common Medicare inpatient procedures and diagnoses. This analysis compared inhospital risk-adjusted mortality rates for 17 inpatient procedures and diagnoses, and inhospital risk-adjusted major complications rates for nine procedures.

Of the nation's approximate 5,000 short-term, non-federal, non-children's, acute care hospitals, only 270 hospitals (approximately 5%) are designated as HealthGrades Distinguished Hospitals for Clinical Excellence (DH-CE). In this study, these 270 Distinguished Hospitals for Clinical Excellence are compared to all other U.S. hospitals to identify trends in outcomes, relative risk, and improvement for the years 2005, 2006 and 2007.

Summary of Findings

HealthGrades' Distinguished Hospitals for Clinical Excellence have lower risk-adjusted mortality and lower inhospital complications compared to all other hospitals. During 2005-2007, they had:

Overall 27 percent lower risk-adjusted mortality across 17 procedures and diagnoses where mortality was the end point of study.
- Risk-adjusted mortality was lower for Distinguished Hospitals for all 17 procedures and diagnoses. In fact, risk-adjusted mortality at Distinguished Hospitals was 18 to 40 percent lower than all other hospitals.
Overall eight percent lower risk-adjusted complications across nine procedures where inhospital complications were the end point of study.
- Risk-adjusted complications were lower across all nine procedures studied. In fact, risk- adjusted complications at Distinguished Hospitals were two to 14 percent lower than all other hospitals

From 2005 to 2007, if all hospitals performed at the level of Distinguished Hospitals:

152,666 deaths may have been prevented.
11,772 inhospital complications may have been avoided.

Distinguished Hospitals showed greater improvement from 2005 to 2007 with an average:

Reduction in risk-adjusted mortality by 18 percent, compared to 13 percent for all other hospitals.
Reduction in risk-adjusted inhospital complications by four percent, compared to 2.5 percent for all other hospitals.

Compared to last year's analysis, the number of states that have one or more Distinguished Hospitals for Clinical Excellence decreased by two.

Thirty-five states have one or more Distinguished Hospitals for Clinical Excellence (compared to 37 last year).
Maryland and Minnesota have the highest percentage of Distinguished Hospitals for Clinical Excellence at 44 percent of eligible hospitals followed by Ohio, Florida and Connecticut at 39 percent, 35 percent, and 33 percent respectively.

Source: HealthGrades Seventh Annual Hospital Quality and Clinical Excellence Study (January 2009)

Read full Health Grades report