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Study suggests hospital mortality rates not accurate measure of quality of care

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Findings in a study reported in the Annals of Internal Medicine suggests that tracking the number of patients who die in the hospital may not be the best way to gauge a hospital’s quality.  Different hospitals have different policies on when to send patients home.  The authors write that merely looking at who dies while in the hospital may miss important indicators  – therefore it makes more sense to look at mortality over a set window, such as whether a patient is still alive 30 days from admission. The authors looked at Medicare claims data for patients who had heart attacks, heart failure, or pneumonia and who were admitted to a hospital between 2004 and 2006.The data encompassed 700,000 admissions for heart attacks, 1.3 million heart-failure cases, and 1.4 million pneumonia admissions at thousands of nonfederal hospitals nationwide. Data were adjusted to account for how sick patients were when they entered the hospital.  The study concluded that in-hospital death rates misrepresent how good a hospital is at caring for patients (source: National Journal)

While post-discharge care may not be directly managed by a hospital, it’s still part of a course of care chosen by that hospital’s medical team. That means that looking at a 30-day window still reflects a hospital’s quality.  One limitation to the study: It relied on Medicare claims data and thus tracked only the mortality rates of patients over age 65. Drye acknowledged that research like her team’s study often relies on Medicare numbers, because Medicare claims data are comprehensive, easy to access, and tracks patients nationwide.

Read full study: Comparison of Hospital Risk-Standardized Mortality Rates Calculated by Using In-Hospital and 30-Day Models: An Observational Study With Implications for Hospital Profiling , Ann Intern Med January 3, 2012 156:19-26;

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