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FACTFILE
The 30-day readmission rates for heart attack, heart failure, and pneumonia also are lower at hospitals in the 15 top-performing systems. Tracking these measures may help hospitals identify patients at risk for problems if discharged too soon. Hospitals that score well may be better prepared for a pay-for-performance structure. n Winning health systems n Peer group of U.S. health systems 26.0 25.0 24.56% 23.55% 24.0 23.0 22.0 21.0 19.71% 20.0 19.55% 19.0 18.62% 18.13% 18.0 17.0 16.0 15.0 Heart attack Heart failure Pneumonia
30-day readmission rate, percent
PATIENT OUTCOMES: READMISSIONS
The top systems have better outcomes in terms of 30-day mortality rates, a closely watched metric that is part of CMS’ value-based purchasing program. Tracking these measures may help hospitals identify patients at risk for postdischarge problems and target improvements in discharge planning and in aftercare processes. n Winning health systems n Peer group of U.S. health systems 15.5 15.0 14.52% 15.10% 14.5 14.0 13.5 13.0 12.5 11.74% 12.0 11.42% 11.25% 11.5 11.01% 11.0 10.5 10.0 Heart attack Heart failure Pneumonia
30-day mortality rate, percent
PATIENT OUTCOMES: MORTALITY
SOURCE: Truven Health 15 Top Health Systems 2013.
SOURCE: Truven Health 15 Top Health Systems 2013.
PATIENT COMPLICATION RATES Patients treated at the winning systems had patient complication rates 3% lower than those at nonwinning system hospitals. Results were fairly consistent among the health system size groupings, but small health systems had the lowest complication rates and outperformed their peers by the widest margin—5%—of the three groups.
n Winning health systems n Peer group of U.S. health systems 1.00
1.00
Complications index
0.99 0.98 0.97
1.00
1.00
1.00 0.98 0.97
0.97
0.96
0.95
0.95 0.94 0.93
All in study
Small
Medium
Large
SOURCE: Truven Health 15 Top Health Systems 2013.
FOLLOWING CARE PROTOCOLS The winning systems had a core measures mean percentage of 97.6% (compared with 96.5% for nonwinning systems). This indicates the winners used recommended core measures of care more consistently than nonwinners.
n Winning health systems n Peer group of U.S. health systems 98.5% Core measures mean percent
98.0% 97.5%
98.4%
97.7%
97.6% 97.2%
97.0%
97.1%
96.8%
96.5%
96.5%
96.0%
96.0% 95.5% 95.0%
All in study
Small
Medium
Large
SOURCE: Truven Health 15 Top Health Systems 2013.
PATIENT LENGTH OF STAY The best health systems achieve better clinical outcomes without compromising efficiencies: Patients treated at hospitals in the winning systems return home sooner, with a median average length of stay of 4.49 days, more than half a day shorter than their peers’ median of 5.06 days. 5.10
5.06
5.10 5.00 4.70 4.60
4.50
4.49
All in study
Small
Medium
Large
SOURCE: Truven Health 15 Top Health Systems 2013.
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Average length of stay, in days
n Winning health systems n Peer group of U.S. health systems 5.2 5.1 5.0 4.9 4.8 4.7 4.6 4.5 4.4 4.3 4.2
THE SCANNER