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Hospital performance measures may not make much difference when it comes to mortality

rates. The researchers analyzed data from Hospital Compare between January 1 and December 31, 2004, and compared hospital performance for heart attack, heart failure, and pneumonia with hospital risk-adjusted death rates, which were measured using Medicare Part A claims data. A total of 3,657 acute care hospitals were included in the study based on their performance reported in Hospital Compare.

Across all heart attack performance measures, the absolute reduction in risk-adjusted death rates between hospitals performing in the 25th percentile versus those in the 75th percentile was 0.005 for inpatient death, 0.006 for 30-day death, and 0.012 for death at 1-year. For the heart failure performance measures, the absolute death reduction was smaller, ranging from 0.001 for inpatient death to 0.002 for 1-year death. For the pneumonia performance measures, the absolute reduction in death ranged from 0.001 for 30-day death to 0.005 for inpatient death.

"Because the differences in hospitals are so small, it is unlikely that this information will be very useful to patients," said Werner. "This is particularly true because patients might not live close to the better hospitals. It is not helpful to know that another hospital is better if it is only a tiny bit better. And it is even less helpful if the better hospital is 50 miles farther and you are having a heart attack. But evaluating hospitals is clearly a good idea and Hospital Compare is an important start. With time, the system will get better. In the meantime, though, effort should be focused on developing new measures that are more tightly linked to the clinical outcomes patients care about."


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Contact: Rick Cushman
rick.cushman@uphs.upenn.edu
215-349-5659
University of Pennsylvania School of Medicine
12-Dec-2006


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