St. Agnes Medical Center was "worse" in gastrointestinal hemorrhage and pneumonia death in 2008. Then in 2009, St. Agnes again scored "worse," but now in three categories, percutaneous coronary angioplasty, congestive heart failure and pneumonia.
Presbyterian Intercommunity Hospital was better in three categories, acute myocardial infarction, acute stroke and pneumonia, in 2008. But in 2009 it was better in six areas, having achieved additional lower mortality scores in gastrointestinal hemorrhage, congestive heart failure and craniotomy.
Parker says the rankings give clues as to what might be going on with a hospital's process of care. "In the case of stroke, for example, we know there's evidence that a timely CT scan and a swallow assessment can help guide the correct treatment decisions, and may prevent death or extend life. Likewise, timely administration of the correct antibiotic to patients with pneumonia has been shown to increase survival rates," he says.
He urges hospitals that received poor scores – or those simply wanting to improve – to go back to the patients' charts "to see whether there were issues with the patient's care."
Hospitals should review to see if there were extenuating circumstances or conditions that may be contributing to certain hospitals having higher death rates.
But isn't it possible that some of this trend is partially explained by patient payer mix and socioeconomic status? The unchangeable "extenuating circumstance?"