HealthGrades: How your hospital—and those nearby—perform on quality

Outcomes vary by local markets, within hospitals

HealthGrades on Tuesday released its annual clinical quality scores for U.S. hospitals, rating about 4,500 providers on 33 common conditions and procedures.

Methodology

HealthGrades analyzed roughly 45 million Medicare hospitalization records for patients at nearly 4,500 short-term, acute care hospitals across the United States between 2012 and 2014. For one condition, HealthGrades also used 2011-2013 all-payer state data.

The organization adjusted the mortality and complications outcomes for clinical risk factors and patient demographics. HealthGrades assessed hospitals' performance on quality based on in-hospital complications, in-hospital mortality, and 30-day post-admission mortality.

HealthGrades then assigned hospitals ratings of one, three, or five stars—for "statistically significantly worse than expected", "as expected," or "statistically significantly better than expected," respectively, for each of the 33 conditions and procedures.

Report findings

In a report, HealthGrades said that patients treated at hospitals who received five stars for a certain procedure had a 65% lower risk of experiencing a complication and a 71% lower risk of dying during their hospital stay compared with if they were treated at a hospital that received a one-star rating for the same procedure. HealthGrades estimated that if all hospitals performed similarly to those that received five stars, more than 220,000 patient lives may have been saved since 2011.

Further, HealthGrades noted that disparities exist both in local markets and within hospitals. For instance, according to the analysis:

  • In Denver, 3.6% of patients who received care for chronic obstructive pulmonary disease (COPD) got treatment at a hospital rated five stars for COPD by HealthGrades, compared with the national average of 11.8%;
  • In Cleveland, 84.2% of patients who received care for valve surgery got treatment at a hospital rated five stars for the procedure by HealthGrades, compared with the national average of 19.3%; and
  • In the Chicago region, 14 hospitals were awarded five-star ratings for heart attack care, while only three of those 14 hospitals received five stars for total knee replacement—with eight receiving one star (HealthGrades report, 10/20; Commins, HealthLeaders Media, 10/20; Marotti, Crain's Chicago Business, 10/20).

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