San Bernardino, Riverside Hospitals Showed High Mortality Rates in Past Studies

Some hospital officials from San Bernardino and Riverside counties "expressed bafflement and surprise" that a national study recently ranked area hospitals' compliance with heart attack and pneumonia treatment guidelines among the lowest in the nation, but several state studies suggest that hospitals "had been on notice for years" about above-average mortality rates from the conditions, the Los Angeles Times reports (Ornstein, Los Angeles Times, 8/1).

Researchers at the Harvard School of Public Health evaluated how hospitals in 40 regions across the country comply with care recommendations for heart failure, heart attack and pneumonia. The study was published in the New England Journal of Medicine.

The region ranked 34th for treatment of congestive heart failure and last in the treatment of pneumonia and heart attack (California Healthline, 7/28).

According to a 2004 report by the Office of Statewide Health Planning and Development, 11 hospitals from 1999 to 2001 in the two counties had more patients die from pneumonia than expected, and the two counties had no hospitals with mortality rates lower than the state average. A separate OSHPD study found that five hospitals in the region had higher-than-expected death rates for heart attack patients from 1996 to 1998. One area hospital had a better rate than expected.

However, the Times reports that some hospitals were ranked highly in the NEJM study after "poor showing[s]" in previous years.

Patrick Romano, a professor of medicine and pediatrics at the University of California-Davis, said, "The question would be, naturally, what did you do when you saw these results several years ago? Did you review your care of these patients?" (Los Angeles Times, 8/1).

Jim Lott, executive vice president of the Hospital Association of Southern California, said, "To have almost an entire region score poorly in the same areas defies logic." Lott said he and some physicians questioned how the results in the Harvard study were drawn (Miller, Riverside Press-Enterprise, 7/29).

KPCC's "KPCC News" on Monday included an interview with Times reporter Charles Ornstein about the studies on death rates for heart attack and pneumonia patients at Inland Empire hospitals (Julian, "KPCC News," KPCC, 8/1). The complete segment is available online in RealPlayer.