The treatment that patients receive for heart attacks, heart failure and pneumonia can be a matter of life and death. And a Lund Report review of federal data on hospital quality shows that for a handful of the state 61’s acute-care hospitals, that life-or-death difference is measurable.
The Centers for Medicare & Medicaid Services data on mortality surveyed nearly every significant hospital in the U.S. to record 30-day survival rates, gathering thousands of data points. Most of the data was not revealing. On 354 Oregon-specific metrics, none of the state’s hospitals stuck out: instead, all either reported mortality rates similar to the national average, or they saw too few patients to be statistically relevant.
But of the state’s 61 hospitals, nine did rank above average or below average on treating at least one condition in 2015.
Asked to comment on the data, Phillip Schmidt, spokesman for Oregon Association of Hospitals and Health Systems, responded by email: “Hospitals across Oregon work every day to provide safe and effective care for every patient. Part of hospitals' continuous improvement process is to report quality data to the State, CMS and other entities in order to continue to learn where there are challenges. Hospitals address these challenges through participation in a number of quality initiatives, including CMS's Partnership for Patients initiative, which aim to create safe, high quality care.”
In 2015, five Oregon hospitals ranked worse than the national average on heart-failure 30-day mortality rate – Asante Three Rivers Medical Center in Grants Pass, Asante Rogue Regional Medical Center in Medford, Salem Hospital, Sacred Heart Medical Center Riverbend in Springfield and Good Shepherd Medical Center in Hermiston.
Of those, Asante Three Rivers Medical Center also ranked worse than the national average on a different metric: death rate for stroke patients.
St. Charles Medical Center in Bend, likewise, ranked worse than average on death rate for stroke patients.
And Asante Rogue Regional Medical Center’s results were mixed, with an above-average ranking to counter its below-average heart failure mortality results. Its acute myocardial infarction 30-day mortality rate was better than the national rate, CMS reported.
The Portland VA Medical Center was the only hospital in Oregon to outrank the national average on two separate metrics: heart failure 30-day mortality rate, and pneumonia 30-day mortality rate.
And OHSU rated better than the national average for death by coronary artery bypass grafting.
A look at several years’ worth of past data also shows that some hospitals in Oregon consistently deliver above-average mortality results, while others consistently lag behind the average.
Salem Hospital and Sacred Heart Medical Center Riverbend have both been on the “worse than the national average” list for multiple years running. Sacred Heart ranked worse than average for heart-failure 30-day mortality rate in 2013, 2014 and 2015, and worse than average for death rate for chronic obstructive pulmonary disease patients in 2014. Salem ranked worse than average for heart-failure 30-day mortality rate in 2013 and 2015, and worse than average for death rate for chronic obstructive pulmonary disease patients in 2014.
The Portland VA Medical Center is Oregon’s only hospital with a multi-year consistent record of outperforming the national average. In data that goes from 2011 to 2015, the VA did better than the national average for heart failure 30-day mortality rate and for pneumonia 30-day mortality rate, every year.
The CMS data does not provide ratings for hospitals, but it does assess hospitals with high-enough volume based on the percentage of patients who die within 30 days of hospitalization. CMS risk-adjusts its data, which means it factors in how sick patients where when they were initially hospitalized – so that hospitals that see sicker, older patients, for example, are not penalized for having higher mortality rates.
Snapshot: Nine Oregon Hospitals’ Mortality Rates Stick Out in 2015
- Portland VA Medical Center: Only hospital in the state to rank above average on two metrics – pneumonia and heart-failure mortality. Has had top performance every year from 2011 through 2015.
- OHSU Hospital better than the national average for death by coronary artery bypass grafting
- Asante Rogue Regional Medical Center: Above average on acute myocardial infarction 30-day death rate, below average on heart failure 30-day mortality rate.
- Asante Three Rivers Medical Center: Only hospital in the state to rank below average on two metrics –death rate for stroke patients and heart failure 30-day mortality rate.
- St. Charles Medical Center Bend: worse than national average death rate for stroke patients.
- Sky Lakes Medical Center worse than national average pneumonia 30-day death rate.
- Salem Hospital: worse than national average heart failure 30-day mortality rate
- Sacred Heart Medical Center Riverbend: worse than national average heart failure 30-day mortality rate
- Good Shepherd Medical Center: worse than national average heart failure 30-day mortality rate
Courtney Sherwood can be reached at [email protected] or follow her on Twitter at @csherwood.
