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VNA of Care New England

Publicly Reported Mortality Predicts Hospital Performance

Hospitals with high performance on publicly reported index conditions have lower overall death rate
TUESDAY, June 25 (HealthDay News) -- Hospital performance on publicly reported medical conditions is indicative of overall hospital mortality rates, according to a study published online June 24 in JAMA Internal Medicine.
Marta L. McCrum, M.D., from the Harvard School of Public Health in Boston, and colleagues used national Medicare data for hospital performance at 2,322 U.S. acute care hospitals to determine whether mortality rates for three publicly reported conditions (acute myocardial infarction, congestive heart failure, and pneumonia) correlate with the hospitals' overall performance. Overall performance was a composite risk-adjusted mortality rate across nine medical conditions and 10 surgical conditions. Data were included for 6,670,859 hospitalizations for Medicare fee-for-service beneficiaries from 2008 through 2009.
The researchers found that the absolute risk-adjusted mortality rate on the combined medical-surgical composite was significantly lower for hospitals in the top versus the bottom quartile of performance on publicly reported conditions (9.4 versus 13 percent). The likelihood of being in the top quartile on the overall combined composite risk-adjusted mortality rate was significantly higher for top performers on publicly reported conditions (odds ratio, 5.3). When medical and surgical performance was considered separately, mortality rates for the index condition were predictive of performance (odds ratios, 8.4 for medical and 2.7 for surgical performance). Weaker associations with overall hospital mortality rates were observed for alternative surrogates of quality (large size: odds ratio, 1.9; teaching status: odds ratio, 2.4).
"Hospital performance on publicly reported conditions can potentially be used as a signal of overall hospital mortality rates," the authors write.
One author disclosed financial ties to the publishing industry.
Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1700429#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1700429 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1700438 )
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