By Tim Krohn
The Free Press
MANKATO
August 27, 2008 12:17 am
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The chance of dying after being admitted to area hospitals is at or below the national average.
The data is part of a first-ever public accounting of mortality rates at thousands of hospitals across the United States.
“It’s a good first step. It brings more transparency,” said Dr. Greg Kutcher, president and CEO of Immanuel St. Joseph’s-Mayo Health System in Mankato.
The data Hospital Compare Web site is operated by the Centers for Medicare & Medicaid Services. (www.hospitalcompare.hhs.gov/hospital/mortalitytool)
The site provides the death rates for three common serious ailments: heart attack, heart failure and pneumonia. (Heart failure is a chronic condition in which the heart is not pumping blood as well as it should. People with heart failure have often had a heart attack.)
ISJ was at the national mortality rate for heart attack and heart failure (16.2 percent and 11.2 percent respectively), and they were below the national average for deaths from pneumonia with 9.2 percent.
The more detailed information is seen as a better way to compare hospitals and hold them accountable. In the past, reports didn’t list actual death rates but simply said a hospital was at, better or below the national average.
Still, Kutcher said looking only at mortality rates misses a broad range of other measures of a hospital’s quality. He said ISJ continues on a systematic and system-wide quality improvement effort.
“We’re very happy about where we’ve come. We keep improving.”
Colleen Spike, CEO of the St. Peter hospital, agrees. “The premise is very good, transparency is good, but I’m not sure we’ve come up with the right structure for people to really compare facilities.”
She said that while the death rate reporting mechanism is sound, it is information that doesn’t offer the depth people really need to make decisions about a hospital’s quality.
“That’s its biggest flaw. If people just look at isolated numbers it can be misleading. That’s true with any reporting mechanism.”
St. Peter was at the national mortality rate average for heart attack patients (16 percent) and better than the average for heart failure and pneumonia (10.4 percent and 10.5 percent respectively.)
Kutcher said ISJ has targeted making improvements in the care of pneumonia and heart failure patients in recent years.
“We weren’t doing as well as we needed to, and in the past couple of years we’ve really improved in both areas.”
Kutcher said those improvements likely aren’t reflected in the mortality rate figures in the current report because the information used is nearly 2 years old.
In the end, he said, patients should look at all available data on a hospital and see how open they are about sharing information and instituting programs for improvement.
The mortality rates on the Web site are adjusted to take into account how sick a patient was when they were admitted to the hospital.
While more telling than in the past, the figures used are still imprecise, particularly for smaller hospitals. That’s because the smaller the number of patients treated, the less certain the hospital’s death rate. It’s easier, for example, to get a more precise rate for a hospital that treats thousands of heart attacks than for a hospital that treats just a few a year.
The Web site compensates for that by including an “interval estimate” — a horizontal bar showing the range into which the actual rate could fall. ISJ for example has a death rate of 16.2 percent for heart attack patients. Their range of death rate is listed at 12 percent to 20 percent.
The data counts deaths if they occur within 30 days of the time the patient was released from the hospital, under the assumption that poor care could result in death weeks after being released.
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