New Report Compares Hospital Mortality Rates for 8 Indicators

In 2007, fewer hospitals had mortality rates below the state average on at least one of eight conditions or procedures than had mortality rates below the state average in 2006, according to a report the California Office of Statewide Health Planning and Development posted online today, the San Francisco Chronicle reports.

According to the report, 25 hospitals had death rates that were significantly lower than the state average on at least one indicator in 2007, down from 33 hospitals that performed better than the state average in 2006.

Conversely, 94 facilities had mortality rates significantly above the state average in at least one area, while 98 hospitals had death rates above the state average on at least one indicator in 2006, the report found.

Joe Parker, director of OSHPD's health care outcomes center, said that teaching hospitals and academic medical centers often had better outcomes on the procedures than other hospitals, but he said that he did not detect any other trends.

Report Details

The study measured hospitals' performance for three medical conditions:

• Acute stroke;
• Gastrointestinal bleeding; and
• Hip fracture.

The study also assessed hospitals' performance on five surgical procedures:

• Carotid endarterectomy;
• Craniotomy;
• Esophageal resection;
• Pancreatic resection; and
• Percutaneous transluminal coronocary angioplasty (Colliver, San Francisco Chronicle, 1/22).

The conditions and procedures are among 15 hospital quality measurements created by the federal Agency for Healthcare Research and Quality (Hines, Riverside Press-Enterprise, 1/21).

California plans to update the study annually and expand it to include other indicators (Girion, Los Angeles Times, 1/22).

Methodology

OSHPD examined almost 200,000 records for the report (Riverside Press-Enterprise, 1/21).  The research examined all 384 acute-care hospitals in California (San Francisco Chronicle, 1/22).

Parker said the state "risk-adjusted" the data to account for differences in hospitals' caseloads (Peyton Dahlberg, Sacramento Bee, 1/22).

Hospitals received copies of the report in 2008 and were given one month to respond to it (Riverside Press-Enterprise, 1/21).

Comments

Parker said consumers should not rely on the report exclusively to make health decisions because it focuses on just eight indicators and offers only one measure of a hospital's performance (San Francisco Chronicle, 1/22).

OSHPD Director David Carlisle said, "It is our hope that the timely release of these new indicators will encourage California hospitals to examine their practices and improve their quality of care and help inform consumers and patients about their health care choices" (Los Angeles Times, 1/22).

Criticism

Jan Emerson, a spokesperson for the California Hospital Association, said that the report did not consider the results of the care that patients received for some conditions before they were hospitalized.  She also criticized the agency's report for relying on billing data that researchers did not verify by comparing it with information from patients' medical records (San Francisco Chronicle, 1/22).

Parker acknowledged that to expedite the report's release, the agency did not audit the records the study was based on for accuracy.

Some administrators whose hospitals did not perform well also disputed the findings, arguing that the study included clinically dead patients transferred from other facilities and did not exclude data on patients whose medical records indicated that they did not wish to be resuscitated (Riverside Press-Enterprise, 1/21).