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Memorial by the numbers: Mixed results reflect local health profile
Wednesday, October 3, 2012
By PAUL COLLINS - Bulletin Staff Writer
Memorial Hospital in Martinsville had death rates worse than the national average for both heart failure and pneumonia patients who died within 30 days of admission, federal data shows.
The findings are from the period of July 1, 2008, through June 30, 2011, according to data on Medicare’s Hospital Compare website (www.hospitalcompare.hhs.gov/).
In response to that finding and others on Hospital Compare, Memorial Hospital CEO Skip Philips and other officials said recently that Henry County has low community health rankings, but the hospital has made a number of improvements since 2011, and performance measures are improving.
According to Hospital Compare, Memorial was the only hospital out of 85 in Virginia and one of 119 hospitals out of 4,821 in the United States that had rates worse than the national death rate for heart failure patients (11.6 percent). The report did not give Memorial’s rate, and it said Virginia’s average was not available.
Memorial was one of eight hospitals out of 89 in Virginia and one of 219 out of 4,844 in the country that had rates worse than the national death rate for pneumonia patients (12 percent). That report also did not give Memorial’s rate, and it said that Virginia’s average was not available.
Attempts by the Bulletin to obtain Memorial’s death rates for heart failure and pneumonia patients were unsuccessful.
According to Philips and the 2012 County Health Rankings Report, Henry County had the 113th worst mortality ranking (referring to sickness and disease) and the 127th worst morbidity (referring to death) ranking out of 131 localities in Virginia. Published online at www.countyhealthrankings.org by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, the rankings assess the overall health of nearly every county in all 50 states, using the most recent data. The data can come from different time periods in recent years, depending on the source and the specific health measure.
“We tend as a community to have a sicker population,” Philips said.
According to the County Health Rankings Report, 28.5 percent of people in Henry County are obese, compared with a national benchmark of 25 percent; 32.6 percent of people in Henry County are physically inactive, compared with a national benchmark of 21.0 percent; 30.5 percent of people in Henry County were smokers, compared with a national benchmark of 14 percent; and 15,409 people were uninsured.
It also showed, among other things, that 12.1 percent of people in Henry County were diabetic, compared with a national benchmark of 8.3 percent; 10.6 percent of people in Henry County drank excessively, compared with a national benchmark of 8 percent; and 25.6 percent of people in Henry County were in fair/poor health, compared with a national benchmark of 10 percent.
According to Hospital Compare data, for the period July 1, 2008, through June 30, 2011, Memorial Hospital rated “no different than” the national death rate for heart attack patients, deaths among patients with serious treatable complications after surgery, rate of readmission for heart attack patients, rate of readmission for heart failure patients, rate of readmission for pneumonia patients, serious complications, collapsed lung due to medical treatment, serious blood clots after surgery, a wound that splits open after surgery on the abdomen or pelvis, accidental cuts and tears from medical treatment, and breathing failure after surgery.
The Hospital Compare report also rated hospitals on dozens of other measures for various periods. The measures in which Memorial varied from the national or state averages by 10 percentage points or more include:
• Heart attack patients given a prescription for a statin at discharge: Memorial, 88 percent; Virginia average, 98 percent; national average, 97 percent.
• Heart failure patients given discharge instructions: Memorial, 74 percent; Virginia average, 94 percent; national average, 92 percent.
• Patients who got treatment at the right time (within 24 hours before or after their surgery) to help prevent blood clots after certain types of surgery: Memorial, 86 percent; Virginia average, 97 percent; national average, 96 percent.
• Patients who reported yes, they definitely would recommend the hospital: Memorial, 57 percent; Virginia average, 67 percent; national average, 70 percent.
Hospital Compare also showed, among other things:
• Average number of minutes before outpatients with chest pain or possible heart attack got an electrocardiogram (a lower number of minutes is better, according to the report): Memorial, 12 minutes; Virginia average, 8 minutes; national average, 8 minutes.
• Outpatients with low back pain who had an MRI without trying recommended treatments first, such as physical therapy (if a number is high, it may mean the facility is doing too many unnecessary MRIs for low back pain, according to the report): Memorial, 43.2 percent; Virginia average, 34.3 percent; national average, 36.8 percent.
• Outpatients who had a follow-up mammogram or ultrasound within 45 days after a screening mammogram. (A number that is much lower than 8 percent may mean there’s not enough follow-up. A number much higher than 14 percent may mean there’s too much unnecessary follow-up, according to the report.): Memorial, 3.3 percent; Virginia average, 7.7 percent; national average, 8.5 percent.
• Memorial ranked better than the national rate for objects accidentally left in the body after surgery, air bubble in the bloodstream, mismatched blood types and severe pressure sores (bed sores), all 0.0 per 1,000 patient discharges at Memorial.
The numbers were small, but Memorial was higher than the national rates for falls and injuries (1.020 per 1,000 patient discharges at Memorial, compared with 0.527 per 1,000 for the U.S.); blood infection from a catheter in a large vein (0.728 per 1,000 patient discharges at Memorial, compared with 0.372 per 1,000 for the U.S.); infection from a urinary catheter (1.165 per 1,000 patient discharges for Memorial, compared with 0.358 per 1,000 for the U.S.); and signs of uncontrolled blood sugar (1.020 per 1,000 patient discharges at Memorial, compared with 0.058 per 1,000 patient discharges for the U.S.)
For many other things measured, Memorial’s scores or rates were equal, better or within several percentage points of state and national averages.
The Associated Press reported recently that Medicare is starting to fine hospitals that have too many patients readmitted within 30 days of discharge due to complications. About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates. The penalties are part of a broader push under President Barack Obama’s health care law to improve quality while also trying to save taxpayers money.
Medicare plans to post details later in October, and people can look up how their community hospitals performed by using the agency’s Hospital Compare’s website.