A new HealthGrades study of patient outcomes at America’s hospitals finds that patients at five-star rated hospitals had a 72% lower risk of dying when compared with patients at one-star rated hospitals—a gap that has held steady over the past years even as overall mortality rates have improved. According to the study, if all hospitals performed at the level of five-star rated hospitals over the 3 years studied, 232,442 Medicare lives could potentially have been saved.
The study analyzed objective mortality and complication rates at all of the nation’s 5,000 nonfederal hospitals using 40 million hospitalization records obtained from the Centers for Medicare and Medicaid Services. The study, the largest of its kind, identified national and state-level trends in hospital care quality and established quality ratings for each hospital, across 26 different procedures and diagnoses.
Looking at overall trends, the study found that hospital mortality rates, on average, have declined by 7.98% over the 3-year period studied, from 2007 to 2009. Of the 17 mortality-based diagnoses and procedures analyzed, only two exhibited increased mortality rates—gastrointestinal surgeries and coronary intervention procedures.
HealthGrades rated individual hospitals with a one-star, three-star, or five-star rating in each of 26 procedures and diagnoses. A one-star rating means that the hospital performed below average, to a statistically significant degree, when compared with the other 5,000 hospitals. A three-star rating means the hospital’s performance was average, and a five-star rating means the hospital outperformed the national average to a statistically significant degree.
Hospitals rated with five-stars had significantly lower risk-adjusted mortality across the three years studied. A typical patient would have a 72.47% lower risk of dying in a five-star rated hospital compared to a one-star rated hospital, and a 53.36% lower risk of dying by going to a five-star rated hospital compared to the US hospital average.
The study also found that the highest unadjusted mortality rates were among sepsis (20.59%), respiratory failure (19.45%), and gastrointestinal surgeries and procedures (10.29%). The most improvement in unadjusted mortality was seen in chronic obstructive pulmonary disease (18.73%), bowel obstruction (14.72%), heart attack (13.68%), and stroke (13.50%).
According to the study, approximately 55.91% (129,949) of the potentially preventable deaths were associated with just four diagnoses: sepsis (48,809); pneumonia (29.017); respiratory failure (26,361); and heart failure (25,762).