Hospital Mortality at Five Star versus One Star Facilities

by Clive Riddle, October 22, 2010

HealthGrades, which touts itself as the “leading independent healthcare ratings organization” has just released a study of patient outcomes at U.S. hospitals, stratified by their ratings, that found “patients at 5-star rated hospitals had a 72% lower risk of dying when compared with patients at 1-star-rated hospitals.”

Other well known ratings and ranking of U.S. hospitals include the U.S. News and World Report rankings of U.S. Best Hospitals, which is based on AHA data in part. Consumer Reports also offers hospital ratings based on results from CMS’ Hospital Consumer Assessment of Healthcare Providers and Systems survey, known as HCAHPS, and CMS directly offers Hospital Compare at Medicare.gov, also providing HCAHPS results.

The Thirteenth Annual HealthGrades Hospital Quality calculated that if all hospitals performed at the level of their 5-star rated hospitals, 232,442 Medicare lives could potentially have been saved from 2007-2009 (the study period.) The study analyzed mortality and complication rates using 40 million hospitalization records obtained from CMS.

The study found overall hospital mortality rates declined by 7.98% from 2007 to 2009. Of the 17 mortality-based diagnoses and procedures analyzed, two experienced increased mortality rates – gastrointestinal surgeries (+8.76%) and coronary intervention procedures (+9.26%). HealthGrades rated individual hospitals with a 1-star (below average), 3-star (average) or 5-star (outperformed national average) rating in each of 26 procedures and diagnoses, from bypass surgery to total knee replacements.

Other findings released from the study included:

• The highest unadjusted mortality rates are among sepsis, respiratory failure, and gastrointestinal surgeries and procedures (20.59%, 19.45%, 10.29%, respectively).
• The most improvement in unadjusted mortality was seen in chronic obstructive pulmonary disease (18.73%), bowel obstruction (14.72%), heart attack (13.68%), and stroke (13.50%).
• Approximately 55.91% (129,949) of the potentially preventable deaths were associated with just four diagnoses: sepsis (48,809); pneumonia (29,017); respiratory failure (26,361); and heart failure (25,762).
• On average, one in nine patients developed a hospital-acquired condition, across the nine procedures evaluated for inhospital complications, from 2007 to 2009.

On average, a typical patient would have a 80.40% lower risk of developing one or more inhospital complications by going to a 5-star rated hospital compared to a 1-star and a 63.64% lower risk of developing one or more inhospital complications by going to a 5-star compared to the U.S. hospital average.