[Stitcher]

US News & World Report
January 15, 2007

Top 10 Hospitals
Honor Roll
http://www.usnews.com/usnews/health/...ls/tophosp.htm

Out of 5,189 hospitals, only 3 percent, 176 in all, are ranked in one or more of the 16 specialties in this year's "America's Best Hospitals." And of those, just 14 qualified for the Honor Roll by ranking at or near the top in at least six specialties—a demonstration of broad expertise. The order is based on points—2 points for ranking in the topmost tier, 1 point for the second tier (View 2006 Methodology).

# 1
Johns Hopkins Hospital, Baltimore
30 points in 15 specialties

# 2
Mayo Clinic, Rochester, Minn.
26 points in 13 specialties

# 3
Cleveland Clinic
23 points in 12 specialties

# 4
Massachusetts General Hospital, Boston
21 points in 11 specialties

# 5
UCLA Medical Center, Los Angeles
20 points in 13 specialties

# 6
New York-Presbyterian Univ. Hosp. of Columbia and Cornell
18 points in 11 specialties

# 7
Duke University Medical Center, Durham, NC
17 points in 10 specialties

# 8
Barnes-Jewish Hospital/Washington University, St. Louis
16 points in 10 specialties

# 9
University of California, San Francisco Medical Center
14 points in 9 specialties

# 10
University of Washington Medical Center, Seattle
13 points in 8 specialties

# 11
Brigham and Women's Hospital, Boston
12 points in 9 specialties

# 12
University of Michigan Hospitals and Health System, Ann Arbor
11 points in 9 specialties

# 13
Stanford Hospital and Clinics, Stanford, CA
8 points in 7 specialties

# 14
University of Pittsburgh Medical Center
7 points in 6 specialties

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Best Hospitals
Neurology and neurosurgery

Updated July 13, 2006

http://www.usnews.com/usnews/health/...pecihqneur.htm

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[chasmo]

The number one on the surgery list, Mayo clinic, has a poor record in my group for DBS Surgery. The others are all rock-solid DBS centers.

just goes to show you that one must throughly investigate and ask the right questions, (we're up to 55 now) to find a good team.

Charlie

[Stitcher]

Annual study finds top hospitals have 28 percent lower mortality rate

'Quality Chasm' remains, according to Healthgrades’ fifth annual hospital quality and clinical excellence study; distinguished hospitals for clinical excellence named; free to consumers online

http://www.eurekalert.org/bysubject/index.php?kw=54

GOLDEN, Colo. (January 29, 2007) – Patients treated at top-rated hospitals nationwide have nearly a one-third better chance of surviving, on average, than those admitted to all other hospitals, according to a study released today by HealthGrades, the leading independent healthcare ratings company. Patients who undergo surgery at these high-performing hospitals also have an average five percent lower risk of complications during their stay, researchers found.

The annual HealthGrades Hospital Quality and Clinical Excellence study, now in its fifth year, identifies hospitals in the top five percent nationally in terms of mortality and complication rates for 26 procedures and diagnoses, from bypass surgery to stroke. Hospitals achieving this level of care quality are designated Distinguished Hospitals for Clinical Excellence by HealthGrades and are identified on the organization's consumer Web site, HealthGrades.com.

Disparities in the level of care patients receive, based simply on where they choose to seek treatment, highlight a troubling phenomenon in the U.S. healthcare system: a preventable, but growing gap between high-quality hospitals and the rest of the field.

The 2007 study found that 158,264 lives may have been saved and 12,409 major complications avoided, had the quality of care at all hospitals matched the level of those in the top five percent.

To name hospitals in the top five percent for clinical excellence, the HealthGrades' study analyzes nearly 39 million hospitalizations over the years 2003, 2004 and 2005 at all 5,122 of the nation's nonfederal hospitals.

In comparing Distinguished Hospitals for Clinical Excellence with all other hospitals, the HealthGrades study finds:

• On average, a 28 percent lower risk of mortality was experienced by Medicare patients at Distinguished Hospitals for Clinical Excellence in the following procedures and diagnoses: cardiac surgery, angioplasty and stent, heart attack, heart failure, atrial fibrillation, chronic obstructive pulmonary disease, community-acquired pneumonia, stroke, abdominal aortic aneurysm repair, bowel obstruction, gastrointestinal bleed, pancreatitis, diabetic acidosis and coma, pulmonary embolism and sepsis.
• For those same procedures and diagnoses, Distinguished Hospitals for Clinical excellence had more than twice as much improvement in hospital complications as all other hospitals, lowering mortality rates over the years 2003, 2004 and 2005 by an average 12 (11.74) percent.
• Medicare patients had, on average, a 5 percent lower risk of post-operative complications at a Distinguished Hospital for Clinical Excellence for diagnoses and procedures that include orthopedic and neurosurgery, vascular surgery, prostate surgery and gall bladder surgery.
• For those same procedures and diagnoses, Distinguished Hospitals reduced post-surgical complication rates by 3.39 percent.

Seventy-five percent of this year's Distinguished Hospitals for Clinical Excellence are being recognized by HealthGrades for the second consecutive year.

"The data in this year's study clearly indicate continued improvement in reducing preventable deaths and complications in U.S. hospitals," said Samantha Collier, MD, HealthGrades' senior vice president of medical affairs. "HealthGrades commends those hospitals for achieving consistent, high-quality care, not just in one or two specialties, but across the board, from orthopedic surgery to cardiac care. However, the continued gap between the nation's top and poorest-performing hospitals continues."

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Individuals can see how their local hospitals are rated, and if they have been designated Distinguished Hospitals for Clinical Excellence, for free at http://www.healthgrades.com.

Methodology

In its 2007 study, HealthGrades independently and objectively analyzed millions of Medicare patient records from fiscal years 2003, 2004 and 2005, for 26 medical procedures and diagnoses. To qualify for the list, hospitals were required to meet minimum thresholds in terms of patient volumes, quality ratings and the range of services provided. Prior to comparing the mortality and complication rates of the nation's hospitals, HealthGrades risk-adjusted the data, to compare on equal footing hospitals that treated sicker patients. Hospitals with risk-adjusted mortality and complication rates that scored in the top five percent or better nationally – which demonstrates superior overall clinical performance – were then recognized as Distinguished Hospitals for Clinical Excellence.

HealthGrades' methodology is open and can be found in the study and on the company's Web site.

About HealthGrades Health Grades, Inc. (Nasdaq: HGRD) is the leading healthcare ratings organization, providing ratings and profiles of hospitals, nursing homes and physicians. Millions of consumers and many of the nation's largest employers, health plans and hospitals rely on HealthGrades' independent ratings and decision-support resources to make healthcare decisions based on the quality of care. More information on the company can be found at http://www.healthgrades.com.

[Stitcher]

Hospital performance measures may not make much difference when it comes to mortality

Current performance measures not enough to predict patient outcomes

Public release date: 12-Dec-2006
http://www.eurekalert.org/bysubject/index.php?kw=55

(PHILADELPHIA) -- Researchers at the University of Pennsylvania’s School of Medicine have found that hospitals with high and low performance on Medicare quality measures had little difference in the rate of death for three common conditions at the hospitals, indicating that the performance measures may not accurately reflect patient outcomes. Senior author Rachel M. Werner, MD, PhD, Assistant Professor of Medicine at the University of Pennsylvania, Core Investigator with the Center for Health Equity Research and Promotion at the Philadelphia Veterans Affairs Medical Center, and colleague Eric Bradlow, PhD, Professor of Marketing and Statistics at the University of Pennsylvania’s Wharton School report their findings in the December 13th issue of JAMA.

In the United States, quality of care delivered in hospitals is often variable. Because it is assumed that measuring quality of care is a key component in improving care, quality measures have an increasingly prominent role in quality improvement, according to background information in the article. These measures can provide an incentive to improve quality of the care delivered and to influence consumer choice of hospitals and health care plans. While some research has documented an association between higher adherence to care guidelines and better outcomes of patients who receive that care, to date there has been limited evidence demonstrating that hospitals that perform better on process measures also have better overall quality.

"What we would like is a kind of ‘Consumer Reports’ for hospitals so that patients can find out which hospitals are better and then go to these hospitals," said Werner. "Medicare has taken an important step toward that goal by publishing hospital performance in all acute care hospitals in the United States on their website, ‘Hospital Compare.’"

This study was conducted to determine whether these quality measures are correlated with and predictive of hospitals’ risk-adjusted death rates. The researchers analyzed data from Hospital Compare between January 1 and December 31, 2004, and compared hospital performance for heart attack, heart failure, and pneumonia with hospital risk-adjusted death rates, which were measured using Medicare Part A claims data. A total of 3,657 acute care hospitals were included in the study based on their performance reported in Hospital Compare.

Across all heart attack performance measures, the absolute reduction in risk-adjusted death rates between hospitals performing in the 25th percentile versus those in the 75th percentile was 0.005 for inpatient death, 0.006 for 30-day death, and 0.012 for death at 1-year. For the heart failure performance measures, the absolute death reduction was smaller, ranging from 0.001 for inpatient death to 0.002 for 1-year death. For the pneumonia performance measures, the absolute reduction in death ranged from 0.001 for 30-day death to 0.005 for inpatient death.

"Because the differences in hospitals are so small, it is unlikely that this information will be very useful to patients," said Werner. "This is particularly true because patients might not live close to the better hospitals. It is not helpful to know that another hospital is better if it is only a tiny bit better. And it is even less helpful if the better hospital is 50 miles farther and you are having a heart attack. But evaluating hospitals is clearly a good idea and Hospital Compare is an important start. With time, the system will get better. In the meantime, though, effort should be focused on developing new measures that are more tightly linked to the clinical outcomes patients care about."
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EMBARGOED FOR RELEASE:
4 P.M (ET) December 12, 2006

PENN Medicine is a $2.9 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System.

Penn's School of Medicine is ranked #2 in the nation for receipt of NIH research funds; and ranked #3 in the nation in U.S. News & World Report's most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System includes three hospitals, all of which have received numerous national patient-care honors [Hospital of the University of Pennsylvania; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center]; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.