Hospital MI Mortality Rates Declining: CMS

July 09, 2010

July 9, 2010 (Washington, DC) — Deaths caused by MI are declining in the US, according to an analysis of data from the Centers for Medicare & Medicaid Services (CMS).

Reported July 7, 2010 in USA Today by Steve Sternberg and Jack Gillum, the CMS analysis showed that the MI mortality rate from the more than 4500 hospitals treating Medicare patients declined from 16.6% to 16.2% in the most recently analyzed three-year period and that all hospitals, including those with the lowest and highest mortality rates, had reductions in death following MI.

"We're in the midst of a remarkable period in American medical history: seeing dramatic improvements in care of heart-attack patients," Dr Harlan Krumholz (Yale University, New Haven, CT), who was involved in the CMS analysis, told USA Today.

As Sternberg and Gillum point out in the article, the CMS has attempted to improve outcomes through public-reporting measures of how consistently hospitals provide guideline-recommended treatments for patients. The public-reporting system was started seven years ago and now uses billing data to measure MI, heart-failure, and pneumonia mortality. In this analysis, heart-failure and pneumonia death rates were unchanged.

Interestingly, an analysis by USA Today showed that two-thirds of the hospitals with the highest death rates were accredited from "one of a handful of groups that strive to improve hospital quality." The Joint Commission, the largest agency, accredits 79% of Medicare-participating hospitals but challenged the findings, telling the reporters that the CMS approach to measuring outcomes, including MI, heart failure, and pneumonia, "isn't very good" because it relies on billing data rather than patient charts.

Krumholz said the next steps are to reduce readmission rates, a measure the CMS reporting system also tracks, which are unchanged from July 2005. Almost 25% of heart-failure patients and 20% of MI patients return to the hospital within 30 days of discharge, raising concerns about the quality of care in the shift from the hospital to home. "The challenge now is to elevate care at the critical juncture, when people are going home from the hospital, an area that's traditionally been ignored," Krumholz told USA Today.

In the story, USA Today also includes an interactive search engine that allows readers to obtain the mortality rates for heart attack, heart failure, and pneumonia at more than 4100 hospitals in the US. The data used for the database is from the CMS and covers a three-year period from mid-2006 to mid-2009.

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