Which States Have Safest Hospitals?

USA Today

October 23, 2012

Arizona, California, Illinois and Ohio scored the best marks for hospital care in a new report that says quality varies “significantly” from state to state in key health areas linked to mortality rates.

During 2005-2011, hospitals in those states outperformed others when treating patients for four key conditions or procedures studied: coronary artery bypass graft, heart attack, pneumonia and sepsis, according to the report to be released today by Healthgrades, a for-profit provider of information about physicians and hospitals. Those four areas combined to make up 54% of all hospital-related deaths in the United States.

Patients have a 55% lower risk of dying when treated in the best hospitals and 42% lower risk of experiencing a complication, the report says. Healthgrades lists state-by-state findings on its website (healthgrades.com), along with hospital affiliations for many doctors.

“People need to know how to make informed decisions,” said Roger Holstein, Healthgrades CEO. “This is the first time we’ve been able to show linkage between a doctor and hospital. It’s particularly important if you’re going to have a surgery. A person can make the best choice by discussing options with his doctor.”

Hospitals in Alabama, Arkansas, Georgia, Nevada, Oklahoma, West Virginia and Washington, D.C., got the lowest grades, although not all the hospitals in those states performed below average. Healthgrades also grades each hospital, and the report says there can be large variances locally.

The differences between states are “substantial,” said Evan Marks, a lead author of the report. “For instance, in Alabama you have a 42% higher risk of dying from a heart attack in a hospital than in Arizona.”

The rankings are based on an analysis of data released annually by the Centers for Medicare and Medicaid Services and look at how approximately 4,500 hospitals nationwide performed on risk-adjusted mortality and complication rates for nearly 30 of the most common conditions and procedures.

But consumers also need to know how factors not accounted for in the Healthgrades report affect hospital outcomes, says Nancy Foster, vice president of quality and patient safety policy for the American Hospital Association.

“People come to us (hospitals) far sicker if they’re from a low-income area,” Foster said. “They might have multiple complications (that have not been adequately treated). They might struggle to find healthy food. They might find it hard to find a safe place to exercise. All are important components of good health outcomes.”

Healthgrades has been ranking hospitals since 2004, but it says this is the first report to examine findings on the state level. Its report also ranks states according to complications likely to arise while in the hospital. Others supplying hospital ratings include U.S. News & World Report, Consumer Reports and the government’s HospitalCompare.

All the ratings help consumers make choices and spur hospitals to “make continuous improvements,” said George Halvorson, chairman of Kaiser Foundation Hospitals. “You can’t make progress without ratings.”

He says Kaiser has put practices in place that have lowered the death rate from sepsis from 30% to under 10% at three dozen hospitals. Sepsis is a condition in which the body has a severe reaction to bacteria. The average mortality rate in the United States is 17.3%.