Higher-Quality Care Could Be A Lifesaver

Hospital patients have a lesser chance of dying when they receive treatment at hospitals ranked higher in quality, according to a study released Monday by researchers at the Harvard School of Public Health.

The authors estimated that 2,200 fewer elderly Americans would die each year from heart attacks, congestive heart failure, and pneumonia in the 3,720-surveyed hospitals if the death rates at the lowest-ranked hospitals matched those at the top-performing ones.

The study’s lead author, Ashish K. Jha, said that the findings could signal an important change in the relationship between consumers and hospitals. Consumers have not been actively engaged in picking care but instead have relied primarily on word of mouth, he said, adding that he hopes patients will now consider this information and become more involved in the choice.

“Picking a hospital where you are going to live or die is an incredibly important decision,” said Jha, who is an assistant professor of health policy and management at the School of Public Health.

The team used statistics from the Hospital Quality Alliance to rank hospital quality, collecting data from almost 90 percent of the nation’s hospitals that treat the three medical conditions measured, according to Jha.

The researchers were trying to determine whether a higher ranking corresponded with better patient outcomes.

The study did not measure overall hospital quality, but instead looked specifically at the care received by patients suffering from heart attacks, congestive heart failure, and pneumonia—three of the most common medical conditions.

“We think that people who are good at treating these conditions tend to be better at treatment in general,” said Foster Professor of Health Policy and Management Arnold M. Epstein, the study’s senior author.

Jha said that the study’s findings suggested that teaching hospitals, larger hospitals, and private non-profit hospitals generally performed better.

But both Epstein and Jha caution that these characteristics should not be used to make assumptions about patient care.

“Delivering systematically good care is not just a matter of individual doctors trying hard,” Epstein said. “It involves organizations having set up systems to make sure that procedures are carried out successfully.”

The results of the study will appear in the July/August 2007 issue of the journal “Health Affairs.”

—Staff writer Abby D. Phillip can be reached at adphill@fas.harvard.edu.