Womens Health Study 2008: Hospital Research

The Fifth Annual HealthGrades Women's Health in American Hospitals Study (June 2008)

For this report, HealthGrades identifies patient outcomes for maternity care and inhospital treatment of cardiovascular disease (CVD) in women using three years of data (2004-2006) in 17 states. The maternity care analysis calculates maternal complication rates for vaginal, cesarean-section (C-section) and patientchoice C-section deliveries. It also includes neonatal mortality rates for all hospitals evaluated. The riskadjusted analysis of inhospital treatment of CVD identifies mortality rates for coronary bypass surgery, valve replacement surgery, coronary interventions, heart attack, heart failure, and stroke for women. The analysis identifies top-performing hospitals to establish a best-practice benchmark against which other hospitals can be evaluated. See Appendices A and B for a list of best-performing hospitals. Specific results for individual hospitals can be found at www.healthgrades.com.

Introduction

The Fifth Annual HealthGrades Women's Health in American Hospitals study analyzes the quality of care at U.S. hospitals for women and their newborns and for heart disease and stroke outcomes in women. The need to better understand the difference in quality outcomes for women seeking maternity care and inhospital treatment for cardiovascular disease is essential given the combined impact these conditions have on the U.S healthcare system.

Each year more women are hospitalized than men. In fact, women account for nearly 60 percent of all hospital admissions. Primarily driven by pregnancy-related conditions, women make up 75 percent of the hospitalizations for patients ages 18-44. For patients 65+, women represent 58 percent of all hospital stays, many of these are related to cardiovascular disease. Childbirth is the most common reason for hospitalization in the U.S. For many women, hospitalization due to childbirth is their first experience with inpatient care. For these women and their families, it is important to have comparative information about the quality differences that exist among hospital maternity care programs.

Cardiovascular disease kills one woman every minute in the U.S.; therefore, it is equally important for women to understand the differences that exist in the outcomes related to the inhospital treatment of cardiovascular disease. These differences exist despite significant gains in awareness, knowledge and perceptions related to cardiovascular disease. These gains have resulted in women taking positive action to lower the cardiovascular disease risk for both family members and themselves.

Despite improvements in education and prevention, variations in outcomes for inhospital care exist for women. The variations are twofold. First, there is a gap in how efficiently cardiovascular disease is identified in women and how effectively the disease is treated in women compared to men. Second, there is variation in outcomes from one hospital to another.

Identifying Outcome Trends and Five-Star Hospitals

Given that childbirth is the number one reason for hospital admissions1 and cardiovascular disease is responsible for 1 in 2.6 female deaths in the U.S. , information regarding the variation in outcomes-based performance among hospitals is essential to improving the quality of care in America. The primary aims of this study are to:

Identify the best-performing U.S. hospitals in maternity care from 2004 through 2006.
Examine the maternal complication trends for vaginal, caesarean section (C-section), and patientchoice C-section deliveries from 2004 through 2006.
Examine the difference in neonatal mortality between best-, average-, and poor-performing hospitals.
Identify the best-performing U.S. hospitals in women's health from 2004 through 2006.
Examine outcome trends for the inhospital treatment of heart disease and stroke in women from 2004 through 2006.

Assessing Maternity Care Outcomes

HealthGrades analyzed more than 12.5 million hospital delivery and neonate records from 2004 through 2006 at over 1,440 hospitals in 17 states. To identify maternity care program performance, HealthGrades studied overall maternal complications rates for vaginal, C-section, and patient-choice C-sections (nonclinically indicated C-sections) as well as neonatal mortality. The best-performing hospitals are those hospitals that have combined rates of maternal complications and weight-stratified neonatal mortality low enough to place them among the top 15 percent of hospitals evaluated.

Assessing Cardiovascular Disease Outcomes in Women

HealthGrades studied heart disease and stroke outcomes in women admitted to U.S. hospitals - more than one million discharges from 2004 through 2006. This study identifies the best-performing hospitals in 17 states specific to the care and treatment of women with cardiovascular disease and highlights differences and trends in mortality outcomes between the best and worst hospitals.

More information on both the maternity care and women's health methodology can be found in the Hospital Report Cards Maternity Care and Women's Health 2008/2009 Methodology white paper at www.healthgrades.com.

Source: The Fifth Annual HealthGrades Women's Health in American Hospitals Study (June 2008)

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