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State Grades Hospitals on Stroke Outcomes, Readmission Rates

On Monday, a state agency released a report that rates 270 hospitals across California for how well those hospitals handle ischemic stroke — including outcomes, mortality and the ability to prevent hospital readmission.

The report from the Office of Statewide Health Planning and Development (OSHPD) ranked acute care hospitals on stroke care in 2012-2013 using risk-adjusted numbers. Hospitals with higher-risk patients were given more leeway than hospitals with a younger, healthier population, according to Merry Holliday-Hanson, manager of the administrative data program at OSHPD.

“We risk-adjust for pre-existing conditions and morbidity [factors], so hospitals get credit for treating those sicker patients,” Holliday-Hanson said. “We were very careful how we determined better or worse. So there’s not much left to chance.”

Nine hospitals showed “significantly higher” levels of care, she said, while five hospitals had distinctly worse ratings for stroke care.

Overall, Holliday-Hanson said, the numbers improved over a similar ranking in the previous year. Mortality rates dropped from 10.6% to 10.4%, and the 30-day readmission rate fell from 12.8% to 12.4%.

“That’s a good sign,” Holliday-Hanson said. “Not just because of better outcomes. It means hospitals are following the stroke guidelines, and increasing their expertise and experience in treating stroke. They are instituting best practices for stroke care.”
The report can be a useful tool for consumers, she said, as well as for insurers that are deciding where to send their plans’ enrollees.

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