Killer Metric Separates Good Hospitals From Bad

Cheryl Clark, for HealthLeaders Media , June 27, 2013

It wasn't known, at least until this week, that a hospital's low mortality rates in these three diagnoses might translate to good survival rates for patients treated at that hospital for other conditions as well.

Now, however, as far as keeping patients alive, it appears from a research paper in JAMA Internal Medicine that there are very good hospitals and those that are, well, bad hospitals, or places from which if you're discharged, you're less likely to survive 30 days, no matter what condition sent you to the hospital to begin with.

The Brigham and Women's Hospital researchers, who include big name researchers such as surgeon and New Yorker contributor Atul Gawande, MD; Karen Joynt, MD; and Ashish Jha, MD and others, found that hospitals with low 30-day mortality rates among patients with those three conditions tend to have low 30-day mortality rates among patients with nine other common medical conditions, and a composite of 10 surgical conditions, too.

I asked Joynt in an interview this week to confirm this "good hospital/bad hospital" assessment of the article's bottom line.

"Yes," she replied. "We found that the publicly reported measures are actually a pretty good surrogate for what's going on overall [in any hospital]. It's not perfect. But if you go to a hospital that does well in acute myocardial infarction, heart failure, and pneumonia, they're much more likely to do well overall."

Indeed, the researchers said so right near the end of the article: "The broader findings from our work support the notion that there may be actually be 'good' and 'bad' hospitals and that performance on a manageable set of key indicators can help identify such institutions."

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1 comments on "Killer Metric Separates Good Hospitals From Bad"

Mary K (6/27/2013 at 3:07 PM)
Unfortunately, I don't have access to the JAMA article to review possible answers to my questions, but I wonder if some of the 30-day mortality could be attributed to health literacy levels of the patients, access to medications, and gaps in access to follow-up care. These would indicate less of a problem with the hospital (and culture) and a bigger issue with society and aid organizations to alleviate care gaps.




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