Mortality Rates for California Hospitals Released

The California Office of Statewide Health Planning and Development (OSHPD) has released their annual report on hospital performance and analysts call the results of the report average. Not what you are hoping for if  you are a California consumer in need of hospitalization.  While any mortality rates seem too high, the results seem to be on par with past years. More importantly, the examination of hospitals and causes of death that occur therein can only lead to improvements and advances that will aim to reduce that average in years to come.

The new report, containing data from the years 2006 and 2007, was released with the purpose of providing perspective on hospital care throughout the state. Inpatient Mortality Indicators, which were developed on the federal level by the Agency for Healthcare Research and Quality (AHRQ), included five guiding categories related to in-hospital deaths after surgery—esophageal resection, pancreatic resection, craniotomy, carotid endarterectomy, and percutaneous transluminal coronary angioplasty; and three indicators of in-hospital deaths for medical conditions—acute stroke, gastrointestinal hemorrhage, and hip fracture. Said conditions and surgeries were chosen because of the varying mortality rates at different hospitals for the same practices and resulting care.

The indicators showed that the highest percentage of mortality in 2007 came with acute strokes, which produced a 10.4 percent rate of death among the 49,915 cases considered. On the other end of the spectrum, carotid endarterectomies only resulted in a 0.4 percent mortality rate.

The significance of the comparison of 2007 to the prior year was that there was an increase in death rates in a number of hospitals. While 25 hospitals showed death rates that improved and stood better than the state average in at least one category, there were 94 hospitals that were worse. However, the prior year showed higher numbers, with 33 hospitals better than average and 98 facilities worse.

Some hospitals, it should be noted, have taken issue with the report. According to the Los Angeles Times, Torrance Memorial Medical Center released a statement noting that the information was flawed, specifically with reference to the hospital’s worse-than-average rating in the gastrointestinal hemorrhage category. The statement noted that some of the patients listed as deceased are, in fact, still alive. “We are very concerned about the validity of all mortality studies for the period 2006-2007 because the programming error extended to all patient types, not just deaths from GI hemorrhage.”

A spokesperson for OSHPD spoke to the accuracy of the report, noting that all hospitals, including Torrance, reviewed and signed off on the results.

The report was also criticized by Cedars-Sinai Medical Center because of its inability to consider deaths that occurred after hospitalization. However, OSHPD noted that the indicators were “starting points for examining hospital quality but does not regard them as definitive measures of quality.” As with any survey or data analysis, many other factors must be considered in the overall examination of the facts, but the results do provide interesting results and fodder for future, more detailed studies. In addition, healthcare providers may be able to use the mortality rates to improve their focus when it comes to particular medical facilities.

It will take some time before 2008 numbers are requested, submitted, and analyzed, but it is the hope of the officials who coordinated the release of the results that improved care will show better results. And it is the intention of OSHPD to expand the categories in the future.

Director of OSHPD David Carlisle noted, “It is our hope that the timely release of these new indicators will encourage California’s hospitals to examine their practices and improve their quality of care and help inform consumers and patients about their healthcare choices.”