News: U.S. News & World Report’s top-ranked cardio hospitals really do provide higher quality care, study finds

CDI Strategies - Volume 12, Issue 56

In a study in JAMA Cardiology, Harvard University researchers examined U.S. News & World’s Report’s list of the top 50 hospitals for cardiovascular care and found that, yes, indeed, they had lower 30-day mortality rates for heart attack, heart failure, and coronary artery bypass grafting (CABG), along with higher patient satisfaction ratings when compared with non-ranked hospitals.

However, 30-day readmission rates for heart attack and CABG were either similar or higher in the top 50 hospitals, HealthLeaders Media reported. Here’s how the readmission rates compared, according to the study:

Condition/procedure

Ranked readmission rate

Non-ranked readmission rate

Acute myocardial infarction

16.7%

16.5%

CABG

14.1%

13.7%

Heart failure

21.0%

19.2%

The higher readmissions rate is not necessarily a black mark for the top hospitals, or the magazine, but more of an indication that 30-day readmissions may not be the best quality metric, according to study co-author Deepak L. Bhatt, MD, MPH, cardiologist, professor at Harvard Medical School, and executive of interventional cardiovascular programs at Brigham and Women’s Hospital in Boston.

“If all your heart failure patients are going home and dying, then none of them will get readmitted so your readmission rate will be zero and that metric will look good,” Bhatt told HealthLeaders Media.. “Unfortunately, from the patient’s perspective, it’s a failure, so that’s why readmissions, in general, can be a flawed metric.”

The study offers a few takeaways, according to Bhatt. First, while the readmission rates may be higher for the top ranked hospitals in some cases, the study shows that patients and hospitals should pay attention to the U.S. News & World Report rankings since they do accurately show which facilities have lower mortality rates.

“Though many hospitals don’t like to admit it, they do spend a lot of time thinking about their own rankings and maybe that’s not such a bad idea,” Bhatt told HealthLeaders Media.

Secondly, the study may be another argument against financial penalties for high readmission rates. It’s better, according to Bhatt, to “focus on quality measures and metrics where we can really improve patient care instead of on ones that might unintentionally be hurting patient care.”

Editor’s note: To read HealthLeaders Media’s full conversation with Bhatt, click here. To read the full study in JAMA, click here. To read about another recent study of readmission and mortality rates, click here.

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News, Quality