AMI, HF, CABG Mortality Rates Lower in Top-Ranked Hospitals, Study Shows

The 30-day mortality rate for acute myocardial infarction (AMI), heart failure (HF) and coronary artery bypass grafting (CABG) may be lower at hospitals that rank in the top 50 of the U.S. News & World Report "Best Hospitals" for "Cardiology and Heart Surgery," according to a report published Nov. 28 in JAMA Cardiology.

David E. Wang, MD, et al., compared 30-day mortality and readmission rates for AMI, HF and CABG, as well as patient satisfaction rates, at the 50 top-ranked hospitals and 3,502 nonranked hospitals. The researchers used publicly available data from the Centers for Medicare and Medicaid Services Hospital Compare dataset to assess mortality and readmission rates and star ratings from the Hospital Consumer Assessment of Healthcare Providers and Systems to analyze patient satisfaction.

Mortality rates at 30 days were lower at top-ranked vs. nonranked hospitals for AMI (11.9 percent vs. 13.2 percent), HF (9.5 percent vs. 11.9 percent) and CABG (2.3 percent vs. 3.3 percent). Top-ranked and nonranked hospitals had similar 30-day readmission rates for AMI (16.7 percent vs. 16.5 percent) and CABG (14.1 percent vs. 13.7 percent), but top-ranked hospitals had higher HF readmission rates (21 percent vs. 19.2 percent). In addition, patient satisfaction was higher at top-ranked vs. nonranked hospitals (3.9 percent vs. 3.3 percent).

The report's finding of similar or higher readmission rates at top-ranked hospitals compared with nonranked hospitals "raises concern that readmissions may not be an adequate metric of hospital care quality," the researchers conclude. In addition, the researchers suggest that hospitals may have placed a greater focus on reducing readmission rates because of financial incentives that are tied to lower readmission rates.

Clinical Topics: Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Cardiac Surgery and Heart Failure, Acute Heart Failure

Keywords: Patient Readmission, Patient Satisfaction, Centers for Medicare and Medicaid Services (U.S.), Medicare, Medicaid, Coronary Artery Bypass, Heart Failure, Myocardial Infarction, National Cardiovascular Data Registries

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