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Public Reporting Shows No Reduction in Hospital Death Rates

According to Medscape, hospital mortality rates did not appear to be improving despite mandatory public reporting. Improvements in mortality have actually slowed since the reporting began, according to the study.

Overview of Hospital Study

Beginning in 2008, the Centers for Medicare and Medicaid Services began to require hospitals to publicly report 30 day mortality rates when it comes to acute myocardial infarction, congestive heart failure, and pneumonia. Before this requirement, hospitals only had to report process of care metrics related to the conditions.

To receive information on the effects of reporting, Dr. Joynt and his colleagues compared the 30 day mortality trends before and after the mandatory reporting. Hospital data from January 2005 through November 2012 was analyzed.

The results were that when process of care metrics were reported, the mortality rate decreased 0.23% per quarter, but when both process of care and mortality rates were reported, the declines were only 0.09%.

When it comes to individual conditions, the investigators saw that the mortality trends were actually unchanged or worse after the reporting began.

It was concluded by the authors that it was unlikely the lack of improvement in mortality signaled that hospitals had reached the “lower limit of what is achievable”, due to the fact that some hospitals actually had lowered mortality rates.

The authors explained, however that only 2% to 3% of hospitals rank as being worse than what was expected. So the explanation that the study was an incentive for improvement is not accurate.

Statistics on Hospital Mortalities

Information provided by Centers for Disease Control and Prevention:

  • Inpatient hospital deaths decreased 8% in 2000, while the number of hospitalizations increased 11%.
  • Over 700,000 people died in the hospital in 2010.
  • In 2000, 2005, and 2010 about a quarter of these deaths were for patients 85 and over.
  • In 2000, there were 2.4 million deaths in the U.S, and 2.5 million in 2010. Both years one third of these deaths occurred in short-stay, general hospitals.

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