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sample of one report you will find at www.COhospitalQuality.org
Heart Attack mortality
rates in Colorado
In a heart attack or stroke emergency, the best choice
for a consumer is the closest hospital.
The science behind
MORTALITY INDICATOR TERMS:
This report uses a scientific method to make sure hospitals who treat
very sick patients do not have unfairly bad rates, and the method adjusts
so that hospitals that treat more healthy patients do not appear unfairly
good. To study this method please go to www.AHRQ.gov
Risk-adjusted Mortality
Rate
When mortality rates are risk-adjusted, the information becomes comparable
among hospitals because the data is adjusted to take into account variations
in severity of illness and risk of mortality among patients. AdjustmentsÊinclude
factorsÊsuch as age, gender,Êother illnesses or complications, and medical
codes (diagnostic groups) for a specific condition or procedure. The risk-adjusted
rateÊestimates what the hospital's rate would have been if the hospital
had a mix of patients identical to an average patient mix of all Colorado
patients for conditions and procedures.
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Research has confirmed
that the rate of patient deaths for certain procedures and conditions
may be associated with quality of care.
An expected range
of patient deaths is predictable for a given procedure or condition; mortality
rates above or below the expected range may have quality implications.
Especially when reviewing mortality rates, remember that medicine is not
an exact science and death may occur even when all standards of care are
followed. These reports provide some information about hospital performance,
but should not be used as a sole source in determining quality. The federal
Agency for Healthcare Research and Quality (AHRQ) has identified four
categories of quality indicators that appear to have a relationship to
the outcome of care provided within hospitals:
• mortality for specific
procedures,
• mortality for specific conditions,
• volume, and
• utilization.
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MORTALITY
FOR SPECIFIC CONDITIONS
Acute
Myocardial Infarction [AMI]
Risk-Adjusted Mortality.
AMI occurs when an artery to the heart (a coronary artery) becomes
blocked. Myocardial means heart muscle, and infarction means an
area of tissue death due to lack of blood supply. It is a life-and-death
emergency. If a heart attack victim gets to an emergency room
fast enough, prompt care dramatically reduces heart damage and
may save the person's life. In
a heart attack or stroke emergency, the best choice for a consumer
is the closest hospital.
Heart Failure
Congestive Heart Failure (CHF) Risk-Adjusted Mortality
It is one of the most common and severe heart diseases affecting
Americans and one of the most common reasons for hospitalization.
Pneumonia
Risk-Adjusted Mortality Rate
It is a medical condition involving an infection in the lungs.
Pneumonia typically is treated with antibiotics. PneumoniaÊis
the third leadingÊreasonÊfor hospitalization in the U.S.
Stroke
Risk-Adjusted Mortality Rate
It is a disruption in the blood supply to the brain. It occurs
when a blood vessel bringing oxygen and nutrients to the brain
bursts, or is clogged by a blood clot or some other particle.
Therefore part of the brain doesn't get the flow of blood it needs
and the nerve cells in the affected area of the brain cannot function.
When nerve cells cannot function, neither can the part of the
body they control. For example, this is what affects a stroke
victim's ability to talk or walk.ÊThe effects of a stroke often
are permanent becauseÊbrain cells that died due to lack of blood
and oxygen carried by the bloodÊcannot be replaced.
Hip Fracture
Risk-Adjusted Mortality
It is a common cause for hospitalization in the elderly. Many
people die in the first six months after hip fracture. The evidence
linking the substantial variation in mortality ratesÊtoÊthe care
providedÊis limited.ÊTherefore, this indicator should be interpreted
with caution. Bleeding of the Stomach or Intestine (Gastrointestinal
[GI] Hemorrhage) Risk-Adjusted Mortality It is the loss of blood
from the esophagus, stomach, small intestine or colon. The evidence
linking provider care to substantial variationsÊin mortality ratesÊis
weak. This indicator should be interpreted with caution.
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MORTALITY FOR
SPECIFIC PROCEDURES
Heart Bypass
Coronary Artery Bypass Graft (CABG) Risk-Adjusted Mortality
Surgery that reroutes or "bypasses" blood around clogged arteries
to improve the ability of arteries toÊcarryÊoxygen to the heart.
Thousands of bypass surgeries are performed each year and the death
rate is relatively low. However, thisÊprocedure requires skill in
the use of complex equipment.
Balloon Repair
of a Heart Vessel
Percutaneous Transluminal Coronary Angioplasty (PTCA)
Mortality This procedure is a non-surgical treatment done to open
blockages in the arteries that carry blood to the heart muscle.
To reduce or eliminate the blockage, a thin tube is threaded through
a major blood vessel in the leg up to the heart, and a small balloon
or other device on the tip of the tube is used.
Neck
Artery Surgery
Carotid Endarterectomy(CEA) Mortality
The carotid arteries are the major arteries in the neck, which carry
blood from the heart to the brain. If blockages develop in these
arteries, stroke or other brain problems may result, which can cause
disability or death. Endarterectomy is a surgery to remove blockages
from these arteries and reduce the chance of stroke.
Hip
Replacement
Risk-Adjusted Mortality
Planned replacement of a diseased hip joint with an artificial joint
is a common procedure.It treats disabling pain or improves hip function.
The mortality rate is low for this procedure. The patients are often
elderly and many have multiple medical conditions.
Skull Surgery
(Craniotomy) Risk-Adjusted Mortality
Rate It is the surgical opening of part of the skull, to gain access
to the underlying structures.This surgery is performed to remove
a brain tumor, repair an aneurysm (ballooning of blood vessels),
inspect the brain, perform a biopsy (removal of tissue for microscopic
examination to establish a diagnosis), or relieve pressure inside
the skull. It is a demanding operation that is sometimes associated
with high risk of disability or death. The mortality rate for this
operation may be high even in the hands of an extremely experienced
neurosurgeon and neurosurgical team. The adjustments used in this
report to equalize "risk" may not fully reflect the many types of
risk associated with this complex surgery, which often is performed
on an emergency basis.
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