Latest hospital report shows improvement in some areas

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In-hospital mortality rates decreased significantly statewide between 2007 and 2011 for four of the 12 conditions included in the latest Hospital Performance Report released Tuesday by the Pennsylvania Health Care Cost Containment Council (PHC4).


The decline in mortality rates were for pneumonia-aspiration, colorectal procedures, kidney and urinary tract infections and chronic obstructive pulmonary disease. No significant change occurred for the other eight conditions.


The findings are contained in the Hospital Performance Report for 2011. The report evaluates hospitals on 12 medical conditions and surgical procedures for which new risk-adjustment processes are complete. It contains hospital-specific information about volume of cases, mortality, readmissions and charges for patients admitted to 157 hospitals in the state.


“The Hospital Performance Report has been one of PHC4’s most popular publications, one that patients and professionals in health care-related fields found extremely useful. We are pleased that we can once again provide this report to the people of Pennsylvania,” said Joe Martin, PHC4 executive director.


At Southwest Regional Medical Center in Greene County, readmission rates were lower than expected for COPD and diabetes.


At Canonsburg General Hospital, the mortality rate was higher than expected for colorectal procedures, and the readmission rate was higher than expected for open gallbladder surgery.


Patty Toner, community marketing manager at Canonsburg General Hospital, responded to the report.


“Canonsburg General is committed to meeting the highest standards of patient care quality across all of its services,” said Toner. “As part of that commitment, we continuously evaluate our clinical performance to ensure those standards are met or exceeded and, just as importantly, to identify opportunities for improvement. We have conducted an extensive review of the two clinical measures in the PHC4 report where our expectations fell short and have taken appropriate steps to enhance our performance in those areas.”


Washington Hospital experienced a higher-than-expected readmission fate for abnormal heartbeat and a higher-than-expected mortality rate for diabetes–medical management.


Officials at Washington Hospital did not immediately respond to a request for comment.


Monongahela Valley Hospital was found to have a statistically significant high mortality rate in the area of congestive heart failure.


In a response to PHC4, Mon Valley Senior Vice President Donna L. Ramusivich said the hospital, as part of its performance improvement program, reviewed all of the 17 patient deaths that occurred out of the 381 patients treated, and identified no areas of concern. Ramusivich wrote that all 17 patients were in end-stage congestive heart failure, and 11 of the 17 patients were discharged to inpatient hospice and died because the patient and family determined that the patient’s condition was terminal. Three patients had do-not-resuscitate orders, and the other three patients had end-stage CHF and additional medical conditions.


Among the report’s other findings:


• For the 12 conditions reported, chest pain had the largest percentage decrease (55 percent) in volume of patients admitted to hospitals in Pennsylvania.


• Chronic obstructive pulmonary disease had the largest percentage increase (22 percent) in admissions.


• Medicare fee-for-service was the primary payer for 41.7 percent of the Pennsylvania admissions in 2010 (the most recent year available) for the 12 conditions and procedures in this report. Those payments totaled more than $755 million.


• The condition with the highest average Medicare fee-for-service payment in 2010 was colorectal procedures, at $18,619 per hospitalization. The condition with the lowest average was chest pain, at $2,678.


The Pennsylvania Health Care Cost Containment Council is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in Pennsylvania. Copies of the Hospital Performance Report are free and available on the council’s website at www.phc4.org.


PHC4 plans to expand the number of conditions and measures in future annual reports.


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