Lower Mortality Seen for Cardiac Care at Top-Ranked Hospitals
But readmission rates similar for top-ranked, nonranked hospitals for acute MI and CABG
(HealthDay News) -- Compared with nonranked hospitals, top-ranked hospitals have lower 30-day mortality but similar or higher readmission rates for cardiovascular conditions, according to a study published online in JAMA Cardiology.
David E. Wang, MD, from Brigham and Women's Hospital in Boston, and colleagues conducted a cross-sectional study involving 3552 US hospitals to examine whether US News & World Report top-ranked hospitals for cardiology and heart surgery perform better than nonranked hospitals on mortality rates and readmission measures.
The researchers found that compared with 3502 nonranked hospitals, the 50 top-ranked hospitals had lower 30-day mortality rates for acute myocardial infarction (AMI; 11.9 vs 13.2%; P < 0.001), heart failure (0.5 vs 11.9%; P < 0.001), and coronary artery bypass grafting (CABG; 2.3 vs 3.3%; P < 0.001). Compared with nonranked hospitals, the 50 top-ranked hospitals had similar readmission rates for AMI (16.7 vs 16.5%; P = 0.64) and CABG (14.1 vs 13.7%; P = 0.15) and higher rates for heart failure (21 vs 19.2%; P < 0.001). Compared with nonranked hospitals, the top-ranked hospitals had higher patient satisfaction (3.9 vs 3.3; P < 0.001).
"It is possible that top-ranked and nonranked hospitals have focused substantial resources on reducing readmissions rather than mortality rates given the financial push of the Hospital Readmission Reduction Program, which resulted in generally similar readmission rates but disparate mortality rates between these hospital groups," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.
Wang DE, Wadhera RK, Bhatt DL. Association of Rankings With Cardiovascular Outcomes at Top-Ranked Hospitals vs Nonranked Hospitals in the United States. JAMA Cardiol. Published online November 28, 2018. DOI:10.1001/jamacardio.2018.3951