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Report card: Key hospital mortality rates decline

| Tuesday, Dec. 18, 2012, 12:01 a.m.

Pennsylvania hospitals significantly cut the mortality rates for patients with four major conditions and reduced readmissions for two conditions, according to the latest Pennsylvania Health Care Cost Containment Council report card.

In Western Pennsylvania, Monongahela Valley Hospital had a “statistically significant high mortality rate” among patients with congestive heart failure, the report says. The hospital reported that 17 of 381 patients with the disease died.

“This is a case where the data is not telling the whole story,” said Donna Ramusivich, the hospital's senior vice president.

The Monongahela facility inadvertently included hospice patient deaths with the hospital deaths, she said. Of the 17 deaths, 11 died in hospice, three hospital patients had do-not-resuscitate orders and three others had other medical conditions and were in the hospital fewer than two days.

Overall, the information on hospitals statewide showed generally positive trends over four years, from 2007 to 2011, said Joe Martin, the council's executive director.

It posted its report online, showing information about volume of cases, mortality, readmissions and charges for 12 major conditions at 157 hospitals statewide. The council released its report annually from the early 1990s through 2009, but stopped for a year while redesigning its methods in response to state statutes.

“I don't see any bad news,” Martin said. “You can look through the report and pick out a particular hospital, but overall the fact that the mortality rates went down is a good sign.”

The Hospital & Healthsystem Association of Pennsylvania welcomed the report as evidence that hospitals' “commitment to high-quality patient care is paying off.”

In-hospital deaths decreased for patients with aspiration pneumonia (from 10 percent to 7.7 percent), colorectal procedures (3.2 percent to 2.6 percent), kidney and urinary tract infections (1 percent to 0.6 percent) and chronic obstructive pulmonary disease, or COPD (1 percent to 0.8 percent).

Among other significant findings, the council reported that:

• Readmissions decreased significantly for patients with COPD and congestive heart failure.

• Hospital admissions for patients complaining of chest pain dropped 55 percent, but those patients experienced an increase in readmissions.

• Medicare fee-for-service was the primary payer for 41.7 percent of patients admitted with the 12 conditions, at a total cost of $755 million.

• Colorectal procedures had the highest Medicare fee-for-service payment in 2010, at $18,619 per hospitalization, while chest pain was the lowest, at $2,678.

Since 2008, the federal Centers for Medicare and Medicaid Services stopped paying hospitals for some types of readmissions that might have been prevented.

Researchers wrote in The New England Journal of Medicine in October that they could find no evidence that the change in the payment policy has had an impact. But Martin said he believes hospitals statewide have taken notice.

“In general, there's a lot of attention and resources going into quality improvement in a lot of different areas, and you're starting to see that reflected in these numbers,” he said.

Andrew Conte is a staff writer for Trib Total Media. He can be reached at 412-320-7835 or andrewconte@tribweb.com.

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