As millions of Americans begin choosing a health plan for the first time under the Affordable Care Act, the new Healthgrades American Hospital Quality Outcomes 2014: Report to the Nation released October 22nd reveals how hospital selection can dramatically impact a patient's health. The report demonstrates that individuals are far more likely to die or suffer complications at hospitals receiving the lowest Healthgrades rating. In fact, each year an estimated 234,252 lives could potentially be saved and 157,418 complications could be avoided if all hospitals performed similarly to the highest rated hospitals.
The report, which is a comprehensive analysis of three years of Medicare outcomes data of 40 million patient records from 4,500 hospitals nationwide, shows that a patient's chance of suffering a complication - or even death - is substantially greater at hospitals receiving Healthgrades one star rating when compared to hospitals receiving a five star rating. In fact, the variation in outcomes differs widely between hospitals within the same community. For example, Healthgrades evaluated 33 hospitals in Atlanta and found that stroke mortality rates were 17 times higher in hospitals receiving one star versus hospitals receiving five stars.
Specifically, the report found that there was a significantly lower risk of dying at a hospital receiving the highest rating for six mortality-based procedures and conditions including:
- COPD: 81.0 percent lower risk of dying
- Colorectal Surgeries: 70.4 percent lower risk of dying
- Pneumonia: 65.9 percent lower risk of dying
- Stroke: 54.6 percent lower risk of dying
- Heart Attack: 48.1 percent lower risk of dying
- Sepsis: 41.9 percent lower risk of dying
"We urge consumers to do their homework when choosing a plan to find out which physicians are covered and whether or not the physician practices at a hospital with a low risk of mortality or complications," said Roger Holstein, Chief Executive Officer of Healthgrades. "Choosing a plan is not just about cost. The most important factor is quality. Consumers should pick their providers before choosing a plan and Healthgrades should be their first stop."
Unfortunately, most people don't realize that their choice of a physician is inextricably linked to the choice of a hospital and its importance in predicting better outcomes. A recent study conducted for Healthgrades by Harris Interactive reveals that fewer than half of Americans over age 26 gather extensive and detailed information before selecting a hospital or physician. In fact, consumers are more likely to choose a hospital based on convenient location (58 percent) or amount of co-pay (45 percent) than based on outcomes data (30 percent). But the importance of choice is significant.
The report also shows that there was a significantly lower risk of having a complication at a hospital receiving a five star rating versus those hospitals receiving a one star rating in four primary complication-based procedures and conditions:
- Hip Replacement: 69.1 percent lower risk of having a complication
- Carotid Surgery: 66.9 percent lower risk of having a complication
- Total Knee Replacement: 63.4 percent lower risk of having a complication
- Gallbladder Removal Surgery: 52.5 percent lower risk of having a complication
"Consumers need accurate information to make meaningful choices between plans," said Archelle Georgiou, M.D., strategic advisor, Healthgrades. "With the Affordable Care Act expanding access to care, it's more important than ever to understand your options, including the quality of care offered at the hospitals and affiliated physicians in your plan."
The Healthgrades report also highlights that better quality can result in lower overall costs. There is a definitive link between higher rates of complications and death and associated increased direct costs for hospitals. In fact, the report shows the direct costs of caring for a patient who experiences a complication are, on average, nearly two times the cost of caring for those patients who did not experience a complication.
Healthgrades report suggests that hospitals can improve outcomes and lower direct costs by using these findings to focus efforts on improving performance. Patients can meaningfully influence their healthcare outcomes by doing their homework to ensure they are making informed choices.
About the Report
Unlike other rating organizations, Healthgrades provides objective measures rooted solely in the domains of science and statistical analysis, leaving perception and reputation out of the equation. Every year, Healthgrades analyzes three years (2010 - 2012) of Medicare Provider Analysis and Review (MedPAR) data to produce a detailed report on mortality and complication rates in America's hospitals. For the 2014 report, Healthgrades analyzed approximately 40 million patient records for nearly 4,500 short-term, acute care hospitals nationwide, assessing hospital performance relative to each of more than 31 common conditions and procedures.
Healthgrades adjusts the report for risk factors that influence patient outcomes. These factors may include age, gender, specific procedure performed, and co-morbid conditions, such as high blood pressure and diabetes. The outcomes reflect clinically-based measures, including in-hospital complications or in-hospital and 30-day post-admission mortality.