HARRISBURG, Pa. (EYT) – Hospitals in Western Pennsylvania showed a decrease in mortality rates and readmissions rates, according to a performance report released last week by the Pennsylvania Health Care Cost Containment Council (PHC4) that included 2013 data.
However, Western Pennsylvania did show an increase in mortality rates for certain diseases such as COPD after accounting for patient risk at the time of admission.
The report also included financial charges for certain conditions and stated that area hospitals such as ACMH Hospital in Kittanning, Clarion Hospital, Brookville Hospital, and UPMC Northwest were generally lower in costs than statewide and Western Pennsylvania averages.
In-hospital mortality rates decreased significantly statewide between 2008 and 2013 for eight of the 16 illnesses for which mortality was reported in the 2013 Hospital Performance Report (HPR), released recently. The sharpest decrease was in Septicemia, a serious and life-threatening infection in the blood stream sometimes referred to as blood poisoning, where the mortality rate decreased from 18.8 percent to 12.2 percent.
None of the conditions and medical procedures studied by PHC4 showed a significant increase in mortality between 2008 and 2013.
The new PHC4 report also indicates statewide patient readmission rates showed a significant decrease in eight of the 13 conditions for which readmissions were reported between 2008 and 2013. The largest significant decrease was in Congestive Heart Failure, where the readmission rate decreased from 27.2 percent to 23.5 percent.
PHC4 is an independent state agency charged with collecting, analyzing, and reporting information that can be used to improve the quality and restrain the cost of health care in Pennsylvania.
COPD decreases in Western Pennsylvania
In Western Pennsylvania, patient readmission rates showed a statistically significant decrease in five of the 13 conditions for which readmissions were reported in 2008 and 2013. Of these, the largest decrease was in Chronic Obstructive Pulmonary Disease (COPD), where the readmission rate decreased from 22.9 percent in 2008 to 19.3 percent in 2013. No condition showed a statistically significant increase during that time.
Patient mortality rates in Western Pennsylvania also showed a statistically significant decrease in seven of the 16 conditions reported in 2008 and 2013. Of these, the largest decrease was in Heart Attack – Medical Management, where the mortality rate decreased from 11.2 percent in 2008 to 8.5 percent in 2013. The only statistically significant increase was in Congestive Heart Failure (CHF), where the mortality rate increased from 2.9 percent in 2008 to 3.6 percent in 2013.
However, after accounting for patient risk, hospitals in the Western Pennsylvania region as a whole had a significantly higher mortality rate than the rest of the state for Chronic Obstructive Pulmonary Disease (COPD), Congestive Heart Failure (CHF), Pneumonia – Aspiration, Pneumonia – Infectious and Septicemia. There were no conditions for which hospitals in the Western Pennsylvania region as a whole had a significantly lower mortality rate than the rest of the state.
After accounting for patient risk, hospitals in the Western Pennsylvania region as a whole had a significantly lower readmission rate than the rest of the state for Chronic Obstructive Pulmonary Disease (COPD) and Diabetes – Medical Management. There were no conditions for which hospitals in the Western Pennsylvania region as a whole had a significantly higher readmission rate than the rest of the state.
Reduced admission rates and improved care
“Reduced rates of readmission can point to an improved quality of care and suggest hospitals in the Commonwealth are working to help lower overall health care costs,” said Joe Martin, executive director of PHC4.
The 2013 HPR evaluates hospitals in the Commonwealth on 17 medical conditions and surgical procedures. The report contains hospital-specific information about volume of cases, mortality, readmissions, and charges for patients admitted to all general acute care and most specialty general acute care hospitals in Pennsylvania.
In addition to Septicemia, other conditions showing significant mortality declines between 2008 and 2013 were:
- Pneumonia – Aspiration: 10 percent to percent
- Heart Attack – Medical Management: 10.2 percent to 8.1 percent
- Kidney Failure – Acute: 5.1 percent to 3.4 percent
- Stroke: 5.1 percent to 3.7 percent
- Colorectal Procedures: 3 percent to 2 percent
- Chronic Obstructive Pulmonary Disease (COPD): 1 percent to 0.6 percent
- Kidney and Urinary Tract Infections: 0.8 percent to 0.5 percent
“The decrease in mortality rates in 2013 correlates to the quality of care hospitals, physicians, and nurses in the Commonwealth provide,” said Martin.
In addition to Congestive Heart Failure, other readmission rates showing declines between 2008 and 2013 were:
- Pneumonia – Aspiration: 25 percent to 21.5 percent
- Kidney Failure – Acute: 24 percent to 21.4 percent
- COPD: 22.8 percent to 20.8 percent
- Kidney and Urinary Tract Infections: 17.6 percent to 15.9 percent
- Pneumonia – Infectious: 17 percent to 16.1 percent
- Stroke: 14.7 percent to 13.9 percent
- Abnormal Heartbeat: 15 percent to 14.5 percent
Only one condition studied showed a significant increase in readmissions between 2008 and 2013—Chest Pain increased significantly from 11.6% to 13.5%.
Medicare, Medicaid payments
Among the HPR’s other statewide findings:
• Medicare fee-for-service was the primary payer for 39.7 percent of the statewide admissions in 2012 for the 17 conditions and procedures studied, totaling more than $1.01 billion.
• Medicaid fee-for-service was the primary payer for 3.0 percent of the statewide admissions in 2012 for the 17 conditions and procedures studied, totaling more than $97 million.
• Medicaid managed care was the primary payer for 4.8 percent of the statewide admissions in 2012 for the 17 conditions and procedures studied, totaling nearly $133 million.
PHC4 publishes the Hospital Performance Report in three regional editions—Southeastern Pennsylvania, Western Pennsylvania, and Central/Northeastern Pennsylvania. Copies of all three are free and available from PHC4’s website at http://www.phc4.org.
Average costs reported
A review of the reports shows the number of cases and the average cost. Area hospitals are included in this summary, but information about other hospitals is available at the website listed above.
Abnormal Heartbeat
Statewide: 41,892 cases, $38,338
Western Pennsylvania: 14,05 cases, $25,698
ACMH: 128 cases, $17,963
Brookville: 15 cases, $10,288
Clarion: 57 cases, $11,825
UPMC Northwest: 161 cases, $16,777
Chest Pain
Statewide: 9,541 cases, $20,730
Western Pennsylvania: 2,279 cases, $12,606
ACMH: 9 cases, $6,771
Brookville: 1 case, NR
Clarion: 0 cases, NR
UPMC Northwest: 22 cases, $8,824
COPD
Statewide: 30,034 cases, $27,327
Western Pennsylvania: 11,062 cases, $16,838
ACMH: 83 cases, $11,396
Brookville: 61 cases, $9,489
Clarion: 61 cases, $9,646
UPMC Northwest: 337 cases, $14,211
Colorectal Procedures
Statewide: 13,140 cases, $80,969
Western Pennsylvania: 4,400 cases, $63,687
ACMH: 49 cases, $29,855
Brookville: 7 cases, $22,149
Clarion: 16 cases, $32,780
UPMC Northwest: 25 cases, $30,060
Congestive Heart Failure
Statewide: 41,749 cases, $34,808
Western Pennsylvania: 14,347 cases, $22,837
ACMH: 128 cases, $14,278
Brookville: 17 cases, $11,617
Clarion: 57 cases, $9,786
UPMC Northwest: 163 cases, $16,145
Diabetes-Medical Management
Statewide: 16,260 cases, $27,387
Western Pennsylvania: 4,733 cases, $17,262
ACMH: 40 cases, $11,524
Clarion: 13 cases, $9,184
UPMC Northwest: 59 cases, $13,287
Gallbladder Removal-Laparoscopic
Statewide: 11,612 cases, $43,785
Western Pennsylvania: 3,665 cases, $29,912
ACMH: 64 cases, $17,185
Brookville: 7 cases, $17,513
Clarion: 13 cases, $16,304
UPMC Northwest: 58 cases, $17,652
Gallbladder Removal-Open
Statewide: 1,598 cases, $68,132
Western Pennsylvania: 521 cases, $50,448
ACMH: 6 cases, $27,929
Clarion: 7 cases, $24,221
UPMC Northwest: 15 cases, $27,531
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