Top Hospitals Across United States Ranked Based on Patient Mortality

Emma Hitt, PhD

January 26, 2010 — A first-ever ranking of the nation's top 50 hospitals based on a comprehensive study of patient death and complication rates at nearly 5000 hospitals has been released this week.

The study was conducted by HealthGrades as part of the ninth annual HealthGrades Hospital Quality and Clinical Excellence study. The analysis was based on approximately 40 million Medicare patient discharges for the years 2007, 2008, and 2009.

The study, led by Kristin Reed, MPH, Carol Nicholas, MSTC, and Rick May, MD, with the healthcare assessment organization HealthGrades, found that West Palm Beach, Florida, ranked first in the nation, with 9 of 12 hospitals in the region designated top performers. Others in the top 5 markets for hospital care quality were Brownsville, Texas; Dayton, Ohio; Minneapolis-St. Paul, Minnesota; and Tucson, Arizona.

Of 4873 short-term, nonfederal, nonchildren's, acute care hospitals included in the analysis, 268 hospitals performing in the top 5% nationwide were identified. A total of 26 different medical procedures and diagnoses were included. "These hospitals as a group have the lowest risk-adjusted mortality and fewest in-hospital complications out of the approximately 5,000 hospitals studied," the authors note in the report.

Hospitals deemed to be in the "distinguished" category had a 29.82% lower risk-adjusted in-hospital mortality rate and a 1.91% lower risk-adjusted in-hospital complication rate among Medicare beneficiaries compared with all other hospitals. The diseases for which the reduction in mortality was greatest at the distinguished hospitals were chronic obstructive pulmonary disease (41.08%) and pneumonia (40.17%).

Thirty-six states had 1 or more distinguished hospitals, with Delaware having the highest percentage (75%) of eligible hospitals, followed by Minnesota (55.56%), Arizona (51.87%), Maryland (36.67%), and Connecticut (35%).

The analysis also ranked cities by highest percentage of distinguished hospitals. The top 10 cities for hospital quality were located in Florida, Texas, Ohio, Minnesota, Arizona, Kentucky, North Carolina, South Carolina, Georgia, Tennessee, and Virginia.

The researchers estimate that if all hospitals performed similarly, 158,684 Medicare lives could potentially have been saved and 3511 Medicare in-hospital complications could be avoided.

The report, which also described the findings of an online survey of 15,000 respondents, indicated that nearly 94% of consumers say they would go out of their way to seek care at a highly rated hospital. Nearly two thirds (64.9%) stated that they would be willing to pay more out of pocket to seek care at a top-rated hospital. In addition, 83.4% of consumers said they are very or somewhat concerned about hospital quality in their community.

"No longer is today's health care consumer simply looking for the least expensive option when it comes to medical care," said Rick May, MD, HealthGrades vice president of clinical quality services and study coauthor, in a written release. "They expect high quality and are willing to go out of their way to get it."

The study was supported for by HealthGrades and conducted by its employees.

The survey is available on the HealthGrades Web site.

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