Study finds new correlation for hospital mortality rates, certain conditions

A recent survey published in JAMA Internal Medicine has shown that hospital performances on publicly reported conditions may potentially signify overall hospital mortality rates.

Harvard School of Public Health researchers used national Medicare data from 2,322 acute care hospitals to examine whether mortality rates for publicly reported medical conditions, which include acute myocardial infarction (heart attack), congestive heart failure and pneumonia, are correlated with a hospital's overall performance. The sample included 6,670,859 hospitalizations for Medicare fee-for-service beneficiaries from 2008 through 2009.

According to Marta L. McCrum, MD, an author of the study from the Harvard School of Public Health, hospitals at the top quartile of performance on publicly reported conditions had a 3.6 percent lower absolute risk-adjusted mortality rate on the combined medical-surgical composite than those in the bottom quartile.

These top performers on publicly reported conditions had five times greater odds of being in the top quartile on the overall combined composite risk-adjusted mortality rate, said McCrum. Mortality rates for the conditions were predictive of medical and surgical performance when these groups were considered separately. Large size and teaching status showed weaker relationships with overall hospital mortality rates, according to the study results.

"I think these findings give us an indication that there are trends that transcend across many conditions that are all related to quality," said McCrum. "The fact that there are these trends leads us to believe that there are also factors in play across all different conditions: leadership, clinical or procedural components, medication checks or lab results"

While McCrum believes more research will need to be done in order to give specific recommendations to hospitals, "the results lead us to believe that hospitals would do well to look at common processes that affect all different services, and look at ways they can optimize those processes. There are commonalities between care for certain conditions, and we really need to figure out what those are and which ones are most important."

"Understanding the systems and leadership characteristics common to hospitals that perform well on publicly reported conditions may help identify components of a truly good hospital that can be used to improve mortality rates at lower-performing institutions," the study concludes.