Patterns of hospital performance in AMI and heart failure 30-Day mortality and readmission

Study shows it matters where patients receive treatment for heart attack

In 2009, the Centers for Medicare & Medicaid Services is publicly reporting hospital-level risk-standardized 30-day mortality and readmission rates after acute myocardial infarction (AMI) and heart failure (HF). We provide patterns of hospital performance, based on these measures. A study in the journal Circulation: Cardiovascular Quality and Outcomes examined data on heart attack and heart failure patients from about 600,000 hospitals across the country between July 2005 and June 2008. The aim of the report is to complement the national release of the hospital-level AMI and HF measures by providing a descriptive summary of the variation in 30-day mortality and readmission rates by region and hospital characteristics.

 

Authors conclude that in a recent 3-year period, 30-day risk-standardized mortality rates for AMI and HF varied among hospitals and across the country. The readmission rates were particularly high.

 

Overall results showed that, while there was room for improvement in care across the board, the hospitals in some states consistently outperformed hospitals in other states in terms of patient mortality or hospital readmission in the 30 days after they received treatment. The median 30-day mortality rate was 16.6% for AMI and 11.1% for HF. The median 30-day readmission rate was 19.9% for AMI and 24.4% for HF. Although there were some differences in average performance by hospital characteristics, there were high and low hospital performers among all types of hospitals.

 

(SOURCES: Journal of Circulation: Cardiovascular Quality and Outcomes, http://circoutcomes.ahajournals.org, Krumholz, Harlan M et al, published online before print, 8 July 2009; ABC News, http://abcnews.go.com, July 10, 2009)