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Fewer Pennsylvanians dying in hospitals for some conditions
Fewer people are dying in Pennsylvania hospitals.
In a report released last week, the Pennsylvania Health Care Cost Containment Council found in-hospital mortality rates showed a significant decrease between January to September 2010 and the same period in 2015.
The report includes hospital-specific outcomes for 17 different medical conditions and surgical procedures at 156 general acute hospitals in the commonwealth, including volume of cases, in-hospital mortality ratings, readmission ratings and hospital charges.
Among the findings, the council found that in-hospital mortality rates showed a statistically significant drop after treatment for kidney failure, pneumonia, heart attacks, colorectal procedures, stroke, kidney infections, chronic obstructive pulmonary disease and congestive heart failure.
Septicemia, or blood poisoning, deaths decreased the most drastically in the time period studied, from 16.1 percent of admissions in 2010 to 10.2 percent in 2015. The number of hospital admissions during the time period studied more than doubled, with 46,139 Pennsylvanians discharged after presenting with the condition in 2015.
“Lower mortality and re-admission rates point to Pennsylvania’s commitment, especially that of Pennsylvania hospitals, to providing quality care,” said Joe Martin, PHC4’s executive director, in a news release. “Reductions in the number of hospitalizations and re-admissions for chronic conditions such as COPD (chronic obstructive pulmonary disease) and CHF (congestive heart failure) are particularly noteworthy since these conditions can be significant cost drivers,” added Martin.
York County: In York County, mortality, re-admission rates and average hospital charges from three area hospitals followed the trend, but statistical decreases were smaller.
According to the report, WellSpan York Hospital, Memorial Hospital and Hanover Hospital all performed as expected. Costs at the three hospitals for the medical procedures examined also fell in line with expected costs for Pennsylvania.
“After reviewing this report, we believe our ongoing improvement efforts are already yielding positive results,” said Dr. Hal Baker, WellSpan Health’s senior vice president for clinical improvement. “As an example, we are expanding the use of patient navigators to help manage certain chronic conditions, such as heart failure and COPD. There has also been an increased focus on our treatment of pneumonia, which can be a contributing factor to COPD.”
Baker said the integrated health care system is committed to providing consistent care across its services, and pointed to diabetes management as another example of WellSpan Health’s effort to standardize patient care.
“We have implemented a dedicated team, including health coaches, which is working to help patients better manage their diets and medications. This focused, integrated approach is designed to bring patients’ blood sugar levels under control. All of these efforts are aimed at improving patient outcomes through consistent, standardized care across our health system.”
Changes: Statewide, hypotension and fainting mortality rates increased from 0.1 percent in 2010 to 0.4 percent in 2015, and 30-day re-admission rates decreased for nine of the 13 conditions reported and increased for chest pain.
In central Pennsylvania, hospitals had in-hospital mortality rates that were significantly higher for five conditions: abnormal heart, colorectal procedures, congestive heart failure, pneumonia aspiration and septicemia, with the greatest difference being a decrease in pneumonia aspiration deaths. Six re-admission rates showed decreases greater than expected in central Pennsylvania, but chest pain re-admission rates increased by 5 percentage points more than expected.
Statewide, the nine conditions with significant reductions in 30-day re-admission rates were:
Pneumonia – Aspiration: 25.3% to 21.6%
Kidney Failure – Acute: 23.6% to 20.1%
Gallbladder Removal – Open: 11.9% to 8.7%
Congestive Heart Failure (CHF): 26.5% to 23.5%
Chronic Obstructive Pulmonary Disease (COPD): 22.6% to 20.0%
Stroke: 14.8% to 12.9%
Kidney and Urinary Tract Infections: 17.7% to 15.9%
Diabetes – Medical Management: 21.8% to 20.5%
Pneumonia – Infectious: 16.0% to 17.1%
Chest pain saw a significant increase in the rate of re-admission, from 11.5% to 15.2%.
Source: PHC4 2015 Hospital Performance Report