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HealthGrades Patient Safety Study Shows Increase in Hospital Incidents, Wide Gaps Among States and Hospitals

Posted on: Monday, 3 April 2006, 09:01 CDT

HealthGrades: Incidents Cost Medicare $9.3 Billion Over 3 Years Patients at Top-Performing Hospitals Have 43% Lower Incidence of Medical Errors Compared to Worst Minnesota, Ranked #1, is Success Story

Patient-safety incidents in American hospitals grew from 1.18 million to 1.24 million among the 40 million hospitalizations covered under the Medicare program, and incidents varied widely from state to state, and among the best and worst hospitals, according to a study released today by HealthGrades, the leading healthcare ratings company.

"Overall we see the number of patient-safety incidents in American hospitals continuing to increase, at an enormous cost, and we still see a large gap between the incidence rates at the nation's top-performing and worst-performing hospitals," said Dr. Samantha Collier, HealthGrades vice president of medical affairs. "But we do find the results of serious attempts to grapple with this issue in the success of top-performing hospitals and in progressive states like Minnesota."

The third HealthGrades Patient Safety in American Hospitals study, the largest annual study of its kind, also finds:

Differences Among Hospitals

-- Medicare patients going to hospitals ranked among the top 15

percent in terms of patient-safety incidents had, on average,

43 percent lower incidence of patient-safety incidents

compared to bottom-ranked hospitals

-- If all hospitals performed at the level of the top 15 percent,

280,134 fewer patient-safety incidents and 44,153 fewer deaths

among Medicare patients would have occurred, saving $2.45

billion during the years 2002 through 2004

-- Of the 304,702 deaths that occurred among patients who

developed one or more patient-safety incidents, 250,246 were

potentially preventable

-- Medicare beneficiaries experiencing one or more patient-safety

incidents had a one-in-four chance of dying during their

hospitalization, a rate that is unchanged since HealthGrades'

first study

Number and Cost of Patient-Safety Incidents

-- Approximately 1.24 million total patient-safety incidents

occurred among the nearly 40 million hospitalizations under

the Medicare program over the years 2002, 2003 and 2004. That

compares with 1.18 million over the previous three-year

period, and 1.14 million over the years 2000, 2001 and 2002

-- These patient-safety incidents were associated with $9.3

billion in excess costs during the years 2002 to 2004

State Rankings and Differences

-- Wide and highly significant gaps in patient-safety incidence

levels were discovered between the top-performing states and

those at the bottom over the years 2002, 2003 and 2004

-- Minnesota, Wisconsin, Iowa, Michigan and Kansas ranked as the

top states for hospital patient safety

-- New Jersey, New York, Nevada, Tennessee and the District of

Columbia ranked last

-- Medicare patients in the best state, Minnesota, had an almost

30 percent overall lower relative risk of developing one or

more of the patient-safety incidents, compared with the worst

state, New Jersey

Trends in Patient-Safety Incidents

-- The patient-safety incidents with the highest prevalence

continue to be failure to rescue, decubitus ulcer and

post-operative sepsis

-- Failure to rescue improved over the study period, while

post-operative sepsis worsened by almost 25 percent

State Rankings

The study ranked the nation's states in terms of the prevalence of patient-safety incidents in each states' hospitals and are grouped as performing better, as expected, or worse than expected to a statistically significant degree: Performed Performed Performed Better Than Expected As Expected Worse Than Expected ---------------------------------------------------------------------- 1. Minnesota 17. West Virginia 42. California 2. Wisconsin 18. Idaho 43. Hawaii 3. Iowa 19. Georgia 44. Arkansas 4. Michigan 20. Maine 45. Maryland 5. Kansas 21. Illinois 46. New Mexico 6. Indiana 22. Massachusetts 47. District of 7. Ohio 23. Colorado Columbia 8. Pennsylvania 24. Oklahoma 48. Tennessee 9. South Dakota 25. Wyoming 49. Nevada 10. North Dakota 26. Oregon 50. New York 11. Montana 27. Rhode Island 51. New Jersey 12. Utah 28. Louisiana 13. Florida 29. North Carolina 14. Washington 30. Missouri 15. Connecticut 31. Alabama 16. Arizona 32. South Carolina 33. Delaware 34. Mississippi 35. Vermont 36. Alaska 37. New Hampshire 38. Texas 39. Virginia 40. Kentucky 41. Nebraska ----------------------------------------------------------------------

Minnesota ranked first overall in this year's state ranking by HealthGrades, and in this state are progressive efforts to improve patient safety. While twenty-five states now have some form of mandatory reporting of medical errors, Minnesota was the first state, in 2003, to legislate mandatory public reporting, using guidelines from the National Quality Forum. Minnesota's Safest in America program allows competitive hospitals to work together to share data, highlight best practices and implement evidence-based, community-tested solutions. Of the eight non-children's hospital systems participating in the Safest in America collaborative, four have hospitals that ranked in the top 15 percent in the national according to this study.

"Two of the patient-safety incidents found in the study to be among the most prevalent are failure to rescue and post-operative sepsis," continued Dr. Collier. "Failure to rescue is the inability to save a hospitalized patient's life when that patient has acquired in the hospital a complication, such as when a patient admitted for a total knee replacement develops pneumonia and dies. An example of post-operative sepsis is when an otherwise previously healthy patient is admitted for a total knee replacement and develops an overwhelming bacterial bloodstream infection requiring potent antibiotics and other treatment resulting in a longer hospital stay and possibly death. Both of these are areas of focus for the most progressive hospitals, who have developed successful ways of minimizing or eliminating deaths from these incidents."

Distinguished Hospital Awards and Findings

Based on the study, HealthGrades identified 238 hospitals reaching the top 15 percent in the nation in terms of patient safety, qualifying them to receive the HealthGrades Distinguished Hospital Award for Patient Safety(TM). The award was designed to highlight hospitals with the best records of patient safety in the nation and to encourage consumers to research their local hospitals' patient-safety records before undergoing a procedure. As a category, Medicare patients at Distinguished Hospitals experienced patient-safety incidents, on average, 43.27 percent less often than patients at the bottom 15 percent of all hospitals.

Methodology

The study is based on 13 patient-safety indicators developed by the Agency for Healthcare Research and Quality (AHRQ), and applied to the most recent MedPar file of Medicare admissions at nearly 5,000 hospitals covering 2002, 2003 and 2004. Teaching hospitals and non-teaching hospitals were evaluated separately, based on a recommendation from AHRQ that hospitals be compared to their peer group. All data was risk-adjusted, so that hospitals with sicker patient populations could be compared equally with others.

The 13 AHRQ indicators are:

-- Death in low mortality Diagnostic Related Groupings (DRGs)

-- Decubitus ulcer

-- Failure to rescue

-- Foreign body left during procedure

-- Iatrogenic pneumothorax

-- Selected infections due to medical care

-- Post-operative hip fracture

-- Post-operative hemorrhage or hematoma

-- Post-operative physiologic and metabolic derangements

-- Post-operative respiratory failure

-- Post-operative pulmonary embolism or deep vein thrombosis

-- Post-operative sepsis

-- Post-operative wound dehiscence

The complete study and methodology can be found at http://www.healthgrades.com.

About HealthGrades

Health Grades, Inc. (Nasdaq:HGRD) is the leading healthcare ratings organization, providing ratings and profiles of hospitals, nursing homes and physicians to consumers, corporations, health plans and hospitals. Millions of consumers and hundreds of the nation's largest employers, health plans and hospitals rely on HealthGrades' independent ratings and decision-support resources to make healthcare decisions based on the quality of care. More information on the company can be found at http://www.healthgrades.com. HealthGrades(R) and Distinguished Hospitals for Patient Safety(TM) are either registered trademarks or trademarks of Health Grades, Inc.

Editor's note: a link to the full study is in the HealthGrades Research section of HealthGrades' home page, http://www.healthgrades.com.

Source: Business Wire

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