Top Hospitals Have 27% Lower Mortality, Annual Study Finds

Medicare patients treated at top-rated hospitals nationwide across the most common Medicare diagnoses and procedures are 27 percent less likely to die, on average, than those admitted to all other hospitals, according to a study released today by HealthGrades, the leading independent healthcare ratings organization. Patients who undergo surgery at these high-performing hospitals also have an average eight percent lower risk of complications during their stay.

The HealthGrades Seventh Annual Hospital Quality and Clinical Excellence study identifies hospitals in the top five percent nationally in terms of mortality and complication rates across 26 procedures and diagnoses, from heart attacks to total knee replacement. Hospitals achieving this level of care are designated as Distinguished Hospitals for Clinical Excellence by HealthGrades and are identified on the organization's consumer website, HealthGrades.com. Many hospitals excel in a given service line, but what differentiates these top hospitals is their quality achievement across a broad range of procedures and treatments, HealthGrades says.

The 2009 study of Medicare patients found that 152,666 lives may have been saved and 11,772 major complications avoided during the three years studied, had the quality of care at all hospitals matched the level of those in the top five percent. The difference between these top hospitals and the rest of the pack highlights a distinct gap between them.

Individuals can see how their local hospitals are rated, and if they have been designated Distinguished Hospitals for Clinical Excellence, for free online.

"This study echoes others that have found distinct quality gaps between top-performing hospitals and others," says Dr. Rick May, MD, HealthGrades senior physician consultant and an author of the study. "Distinguished Hospitals for Clinical Excellence comprise a group of hospitals that excel across the board, not just in one or two specialties, and they should be commended for their relentless commitment to exceptional patient care."

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Child Deaths Fall Below 10 Million For First Time

Global child deaths have reached a record low, falling below 10 million per year to 9.7 million, down from almost 13 million in 1990, according to UNICEF.

"This is an historic moment," says UNICEF Executive Director Ann Veneman. "Now we must build on this public health success to push for the achievement of the Millennium Development Goals."

Among these goals, which range from halving extreme poverty to halting the spread of HIV/AIDS, is a commitment to a two-thirds reduction in child mortality between 1990 and 2015, a result which would save an additional 5.4 million children by 2015.

However, Veneman points out that there is no room for complacency. "The loss of 9.7 million young lives each year is unacceptable. Most of these deaths are preventable and, as recent progress shows, the solutions are tried and tested. We know that lives can be saved when children have access to integrated, community-based health services."

Twenty-five years ago, UNICEF envisioned and launched its "Child Survival and Development Revolution" aimed at sharply reducing childhood death, disease and disability in the developing world. UNICEF insisted that simple, low cost interventions such as immunization, exclusive breastfeeding and growth monitoring, when taken to mass scale, could yield dramatic gains for child survival.

This first-of-its-kind effort was highly controversial within and outside of the organization. Critics argued it was naive, impossible and too simplistic. UNICEF pushed ahead, enlisting the support of hundreds of NGOs, individuals, governments and others in the "revolution." As a result of these partnerships and years of quiet effort, children today are more than twice as likely to survive past the age of five than they were 40 years ago.

"Thanks in large part to many outstanding partnerships and the extraordinary compassion and support of the American public, more children are surviving today than ever before," says U.S. Fund for UNICEF President and CEO Caryl Stern. "UNICEF's relentless focus on saving children's lives will continue until we reach the day when no mother has to grieve the loss of her baby to malaria, diarrhea, measles, or pneumonia."

The new figures are drawn from a range of national data sources, including two sets of household surveys, the Multiple Indicator Cluster Surveys (MICS) and the Demographic Household Surveys (DHS). The current round of MICS surveys was conducted in over 50 countries in 2005-06 and, together with the USAID- supported Demographic and Health Surveys (DHS), are the largest single source of information of the Millennium Development Goals and form the basis of the assessment of progress in child survival.

Their findings reinforce reports of progress released earlier this year on measles mortality, with a 60 per cent fall in measles deaths since 1999, and a 75 per cent reduction in sub-Saharan Africa.

Rapid declines in under-five mortality have been seen in Latin America and the Caribbean, Central and Eastern Europe and the Commonwealth of Independent States (CEE/CIS) and East Asia and the Pacific.

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Nearly 28,000 US Infants Died in 2004

Preterm birth contributes to more than one-third of all infant deaths, according to a U.S. National Vital Statistics report.

Although the national infant mortality rate is the lowest it's been since the U.S. started collecting data a century ago, there's been little change recently – 6.78 deaths for every 1,000 live births in 2004 compared to 6.89 in 2000, the US National Center for Health Statistics (NCHS) report finds.

The report, "Infant Mortality Statistics from the 2004 Period Linked Birth/Infant Death Data Set" includes a new analysis tracking preterm birth-related infant deaths. The analysis, first published in the October 2006 edition of Pediatrics, found preterm birth contributes to nearly twice as many infant deaths within the first year of life than previously estimated.

"We have long known babies born too soon face many developmental challenges – even death," says Joann Petrini, director of the March of Dimes Perinatal Data Center. "This closer look at preterm birth gives us a better understanding of the impact of prematurity on infant survival and provides insights into the factors that have contributed to the lack of improvement in the U.S. infant mortality rate."

Preterm related deaths accounted for more than 10,000 of the nearly 28,000 infant deaths in 2004, according to the NCHS. Birth defects remain the leading cause of infant death, followed by prematurity, according to official reporting systems. But, using this new classification, premature birth would be the most frequent cause of infant death. The traditional methods cannot accurately gauge the true impact of preterm birth on the infant mortality rate, the NCHS says.

The new method reviews all causes of infant death and combines conditions, such as respiratory distress syndrome, which frequently occur in premature babies. The analysis published in October 2006 looked at only the top 20 leading causes of infant death.

More than a half million babies are born too soon each year and the preterm birth rate has increased more than 30 percent since 1981.


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