Patients Less Likely to Experience Safety Incident at Top-Rated Hospitals

A study released today by HealthGrades found that patients have a 46 percent lower risk of experiencing a patient safety incident at a top-rated hospital compared to a poorly rated hospital. The findings are from the annual HealthGrades Patient Safety in American Hospitals study, which analyzed 40 million Medicare patient records, from 2007 to 2009. HealthGrades utilized the patient safety indicators published by the Agency for Healthcare Research and Quality (AHRQ) to identify preventable medical mistakes that occurred during patients' hospitalizations.

Study findings show that, despite encouraging research from the Centers for Disease Control and Prevention showing reductions in hospital acquired bloodstream infections in certain patients, progress is inconsistent. Some hospitals have made rapid progress in reducing infection rates, but hospitals continue to show wide variation in their rates. For example, HealthGrades found that patients treated at those hospitals performing in the top 5 percent in the nation for patient safety were, on average, 52 percent less likely to contract a healthcare-acquired bloodstream infection or to suffer from post-surgical sepsis than those treated at poor-performing hospitals. Nearly 1 in 6 patients who acquired a bloodstream infection while in the hospital died, the study found.

"HealthGrades commends the efforts of those hospitals that are focused on providing consistent, safe and effective medical care," says Rick May, MD, HealthGrades' vice president of clinical quality services and co-author of the study. "But the fact remains that there are huge, life-and-death consequences associated with where a patient chooses to seek hospital care. Until we bridge that gap, HealthGrades urges patients to research the patient safety ratings of hospitals in their community and know what steps they can take to protect themselves from error before being admitted."

HealthGrades used the AHRQ's 13 patient safety indicators incidents such as foreign objects left in a body following a procedure, excessive bruising or bleeding as a result of surgery, bloodstream infections from catheters, and bed sores to identify those hospitals performing in the top five percent in the nation, naming them Patient Safety Excellence Award recipients. The list of these hospitals, along with clinical quality ratings for all of the nation's nearly 5,000 hospitals, can be found at HealthGrades.com.

HealthGrades Patient Safety in American Hospitals study also found regional variation in the prevalence of medical errors and preventable deaths and complications. Rankings by state and by metropolitan area can be found in the full study. The 10 U.S. cities with the lowest incidence of patient safety incidents are: Minneapolis-St. Paul; Wichita, Kan.; Cleveland; Wilkes-Barre, Pa.; Toledo, Ohio; Boston; Greenville, S.C.; Honolulu; Charlotte, N.C.; and Oklahoma City.

Key findings of the HealthGrades Patient Safety in American Hospitals study include:

- Medicare patients treated at hospitals recognized with a HealthGrades Patient Safety Excellence Award had, on average, a 46% lower risk of experiencing a medical error compared to patients treated at bottom-ranked hospitals.

- Patients treated at top-ranking hospitals for patient safety had a 52 percent lower risk of experiencing a central-line bloodstream infection or post-surgical sepsis, another type of hospital-acquired bloodstream infection.

- Four patient safety indicators (death among surgical inpatients with serious treatable complications, pressure ulcer, post-operative respiratory failure, and post-operative sepsis) accounted for 68.51 percent of all patient safety events during the three years analyzed.

- The 13 patient safety events studied were associated with $7.3 billion of excess cost, which equates to an additional $181.17 per Medicare patient hospitalization.

- Preventable medical errors are so pervasive and costly that the federal government has proposed linking incentive-based hospital compensation to four of the AHRQ Patient Safety Indicators, starting in 2014. In addition, the Centers for Medicare and Medicaid Services are currently developing a 10-year, $70 billion plan aimed at reducing hospital-acquired infections.

In this analysis, HealthGrades independently and objectively analyzed approximately 40 million Medicare patient records from fiscal years 2007 through 2009. To be included in the analysis, hospitals must have met minimum thresholds in terms of patient volumes, quality ratings, and the range of services provided. Individuals may compare their local hospitals online at HealthGrades.com. HealthGrades' hospital ratings are independently created; no hospital can opt-in or opt-out of being rated, and no hospital pays to be rated. Patient safety incidence rates are risk adjusted utilizing AHRQ's methodology, which takes into account differing levels of severity of patient illness at different hospitals and allows for hospitals to be compared equally.