2013_HospitalQualityinSouthCarolinaReport

7/31/2019 2013_HospitalQualityinSouthCarolinaReport

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Hospital Quality in South CarolinaIn ourAmerican Hospital Quality Outcomes 2013: Healthgrades Report to the Nation, Healthgrades measured the quality of

care at nearly 5,000 hospitals nationwide for 28 common conditions and procedures, 18 of which are based on anassessment of mortality rates, 10 of which are based on complication rates. A unique feature of this years national report is

the inclusion of supplemental state reports for 50 U.S. states and the District of Columbia, like this one, showing how quality

varies among hospitals within each state.

In this state report, we provide two perspectives to help evaluate the relative performance of South Carolina to the U.S. as a

whole. First, we look at risk-adjusted mortality and complication rates in each of the cohorts studied in South Carolina and

compare them to rates observed for the U.S. as a whole. Second, we evaluate the distribution of the number of hospitals in

South Carolina across each of Healthgrades three performance categories: Statistically better than expected (5-Star), not

statistically different than expected (3-Star), and statistically worse than expected (1-Star). We then compare the state

hospital distribution to the hospital distribution observed for the U.S. as a whole.

Our studies are objective and unique in evaluating hospitals solely on clinical outcomesrisk-adjusted mortality and

complication rates. Below are highlights of our findings for the 60 hospitals evaluated in South Carolina.

Mortality-Based Conditions & Procedures - Performance Highlights

For mortality rate-based procedures and conditions, Healthgrades measures the mortality rate after adjusting for patient

characteristics such as age, gender and clinical risk factors.

During the 2009-2011 study period:

South Carolina did not perform statistically better than the U.S. as a whole in any of the 18 mortality rate-basedcohorts studied during the period; however, there were groups of individual hospitals that did. South Carolina had

6.3% of hospitals in Coronary Artery Bypass Surgery (CABG), 5.6% of hospitals in Coronary Interventional

Procedures (Angioplasty/ Stent) and 4.8% of hospitals in Respiratory Failure that performed at levels that were

statistically better than expected (5-Star).

South Carolina, as a whole, performed statistically worse in risk-adjusted mortality than the U.S. average inHeart Attack(8.0% vs 7.4%), Heart Failure (4.0% vs 3.2%), and Stroke (6.0% vs 5.3%).

While South Carolina had worse than expected performance in Heart Attack, this poor level of performance wasnot observed everywhere in the state. In fact, 2.8% of hospitals performed statistically better than expected in

Heart Attack across South Carolina. It should be noted however, that this percentage is lower than the

percentage of hospitals that performed better than expected in the nation.

Your risk of harm or death can be significantly lower at better performing hospitals. Research your nearby hospitals for the

specific care that you need.

Copyright 2012 Health Grades, Inc. All rights reserved.
http://www.healthgrades.com/find-a-hospitalhttp://www.healthgrades.com/find-a-hospital


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Complication-Based Conditions & Procedures - Performance Highlights

A hospital-acquired complication is any condition that arises while you are in the hospital that is unlikely to be related to your

condition when you were first admitted. Complications may prolong your hospital stay and increase costs. Complication

rates are also adjusted for patient characteristics such as age, gender and clinical risk factors.

During the 2009-2011 study period:

South Carolina, as a whole, performed statistically better in risk-adjusted complications than the U.S. average inCarotid Surgery(10.2% vs 12.7%), and Back and Neck Surgery (Spinal Fusion) (15.9% vs 18.7%).

While South Carolina had better than expected performance in Carotid Surgery, this high level of performancewas not observed everywhere in the state. In fact, 4.3% of hospitals performed statistically worse than expected

in Carotid Surgery across South Carolina which, on the bright side, is lower than the percentage of hospitals that

performed worse than expected in the nation.

South Carolina did not perform statistically worse than the U.S. as a whole in any of the 10 complication rate-based cohorts studied during the period; however, there were groups of individual hospitals that did. South

Carolina had 28.1% of hospitals in Hip Replacement, 17.5% of hospitals in Total Knee Replacement and 10.3% of

hospitals in Prostatectomy that performed at levels that were statistically worse than expected (1-Star).

The following sections of this report:

Illustrate the range of hospital performance within South Carolina for four key mortality rate-based conditionsand procedures and three complication-rate based conditions and procedures.

Summarize performance levels for all conditions and procedures studied by Healthgrades, including thepercentages of hospitals receiving 5-stars, 3-stars and 1-star for performance in each.

Your risk of complications can be significantly lower at better performing hospitals. Research your nearby hospitals for the

specific care that you need.

http://www.healthgrades.com/find-a-hospitalhttp://www.healthgrades.com/find-a-hospital


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Average Hospital Performance(Mortality Rate-Based Cohorts)

On the scale above, green depicts states

with a lower average risk-adjusted mortality

rate and red depicts states with a higher

average risk-adjusted mortality rate.

Risk-Adjusted Mortality Rate-Based Conditions and Procedures

To evaluate quality for mortality rate-based conditions and procedures in this

report, Healthgrades focuses on four key mortality rate-based cohorts: Coronary

Artery Bypass Graft (CABG), Heart Attack, Pneumonia and Sepsis.

Together, these four key cohorts account for more than half of all deaths (54.2%)

among all mortality rate-based conditions and procedures studied by Healthgrades.

These four cohorts also account for 33% of the total number of patients in mortality

rate-based cohorts included in the 2009-2011 analyses. In addition, these four

conditions and procedures are in the top 10 primary diagnoses for all patient

discharges nationwide.

5-star level indicates that the cohort-specific risk-adjusted mortality rate was statistically better than expected (90% confidence interval).

3-star level indicates that the cohort-specific risk-adjusted mortality rate was not statistically different than expected (90% confidence interval).

1-star level indicates that the cohort-specific risk-adjusted mortality rate was statistically worse than expected (90% confidence interval).

South Carolina

U.S.

Heart Attack

36 Hospitals Evaluated

Coronary Artery Bypass Graft


Sepsis


Pneumonia


Distribution of Hospital Performance in Key Mortality Rate-

Based Conditions and Procedures

The figures below illustrate the percentages of hospitals in each of three

performance categories (5-star, 3-star and 1-star) for each of the key conditionsand procedures. These performance categories are based on in-hospital mortality

rates. The differences in outcomes that patients experience differ dramatically

between these three performance categories. The best quality of care for a specific

condition or procedure is found at hospitals performing at the 5-star level

(statistically better than expected) for that condition or procedure.



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Average Hospital Performance(Complication Rate-Based Cohorts)

On the scale above, green depicts states

with a lower average risk-adjusted

complication rate and red depicts states

with a higher average risk-adjusted

complication rate.

Risk-Adjusted Complication Rate-Based Conditions and Procedures

To evaluate quality improvements for complication rate-based cohorts,

Healthgrades examines three key complication rate-based cohorts: Hip Fracture

Treatment, Total Knee Replacement, and Gallbladder Surgery.

These three common procedures performed by hospitals may result in one or more

hospital-acquired complications during the hospital stay. Together, they account

for 66% of all complications and 59% of all patients in the complication rate

conditions and procedures studied by Healthgrades.

5-star level indicates that the cohort-specific risk-adjusted complication

rate was statistically better than expected (90% confidence interval).


rate was not statistically different than expected (90% confidence

interval).


rate was statistically worse than expected (90% confidence interval).

South Carolina

U.S.

Hip Fracture Treatment


Total Knee Replacement


Gallbladder Surgery


Distribution of Hospital Performance in Key Complication

Rate-Based Conditions and Procedures

The figures below illustrate the percentages of hospitals in each of three

performance categories (5-star, 3-star and 1-star) for each of the key conditions

and procedures. The differences in outcomes that patients experience differ

dramatically between these three performance categories. The best quality of carefor a specific condition or procedure is found at hospitals performing at the 5-star

level (statistically better than expected) for that condition or procedure.



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Table 3: South Carolina Hospitals Performance SummaryMortality (M)

Complication (C)

Rates* % of Hospitals Performing at

Condition/Procedure Performance Level **

#

Hospitals M / C

State

Average

(U.S.)

5-Star

Level

(U.S.)

3-Star

Level

(U.S.)

1-Star

Level

(U.S.)

Cardiovascular Service Line

Coronary Artery Bypass

Surgery (CABG)

As expected 16 M 2.0%

(2.2%)

6.3%

(7.7%)

87.5%

(80.4%)

6.3%

(11.9%)

Coronary Interventional

Procedures (Angioplasty/Stent)


(2.2%)

5.6%

(9.2%)

83.3%

(77.1%)

11.1%

(13.8%)

Heart Attack Worse than expected 36 M 8.0%

(7.4%)

2.8%

(13.0%)

80.6%

(73.3%)

16.7%

(13.8%)

Heart Failure Worse than expected 58 M 4.0%

(3.2%)

1.7%

(12.3%)

74.1%

(69.6%)

24.1%

(18.1%)

Valve Repair/Replacement

Surgery


(5.1%)

0.0%

(10.4%)

92.9%

(75.5%)

7.1%

(14.1%)

Critical Care Service Line

Diabetic Acidosis and Coma As expected 32 M 1.5%

(1.3%)

0.0%

(0.1%)

84.4%

(92.2%)

15.6%

(7.7%)

Pulmonary Embolism Worse than expected 31 M 4.6%

(3.8%)

3.2%

(4.8%)

80.6%

(87.3%)

16.1%

(7.9%)

Respiratory Failure As expected 42 M 17.2%

(16.4%)

4.8%

(18.5%)

71.4%

(63.5%)

23.8%

(18.0%)

Sepsis Worse than expected 52 M 20.9%

(17.3%)

3.8%

(21.5%)

46.2%

(49.0%)

50.0%

(29.5%)

Gastrointestinal Service Line

Bowel Obstruction Worse than expected 46 M 3.0%

(2.5%)

0.0%

(5.8%)

91.3%

(83.1%)

8.7%

(11.2%)

Gallbladder Surgery As expected 39 C 26.2%

(26.8%)

5.1%

(14.1%)

92.3%

(71.0%)

2.6%

(14.8%)

Gastrointestinal Bleed Worse than expected 51 M 2.1%

(1.7%)

7.8%

(5.5%)

66.7%

(83.1%)

25.5%

(11.4%)GI Surgeries and Procedures Worse than expected 33 M 11.7%

(10.7%)

0.0%

(10.3%)

78.8%

(77.2%)

21.2%

(12.6%)

Pancreatitis Worse than expected 30 M 2.8%

(2.2%)

0.0%

(1.8%)

80.0%

(89.8%)

20.0%

(8.5%)

Neurosciences Service Line

Neurosurgery As expected 15 M 6.9%

(6.2%)

0.0%

(10.4%)

80.0%

(78.6%)

20.0%

(10.9%)

Stroke Worse than expected 43 M 6.0%

(5.3%)

4.7%

(13.9%)

67.4%

(68.9%)

27.9%

(17.2%)

South Carolina Hospitals Performance Summary

The following table provides a detailed look at how well South Carolina hospitals performed as a

group for all conditions and procedures studied by Healthgrades.



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Note: Although Healthgrades has evaluated hospitals for quality performance in Appendectomy, it is available only for 19 states and so is not covered in this report.

* Mortality and complication rates are risk adjusted to account for differences in severity of illness and other patient factors.

At the hospital level:

5-star level indicates that the cohort-specific risk-adjusted mortality or complication rate was statistically better than expected (90% confidence interval).

3-star level indicates that the cohort-specific risk-adjusted mortality or complication rate was not statistically different than expected (90% confidence interval).

1-star level indicates that the cohort-specific risk-adjusted mortality or complication rate was statistically worse than expected (90% confidence interval).

** When assessing state level performance, a 95% confidence interval was used to determine if the average risk-adjusted mortality or risk-adjusted complication rate,

calculated across all patients in the state, was statistically different than the national average rate.

South Carolina Hospitals Performance Summary (continued)

Mortality (M)

Complication (C)

Rates* % of Hospitals Performing at

Condition/Procedure Performance Level **

#

Hospitals M / C

State

Average

(U.S.)

5-Star

Level

(U.S.)

3-Star

Level

(U.S.)

1-Star

Level

(U.S.)

Orthopedic Service Line

Back and Neck Surgery

(except Spinal Fusion)

As expected 22 C 13.2%

(14.0%)

18.2%

(17.4%)

54.5%

(65.6%)

27.3%

(17.1%)

Back and Neck Surgery

(Spinal Fusion)

Better than expected 26 C 15.9%

(18.7%)

30.8%

(21.3%)

61.5%

(59.2%)

7.7%

(19.6%)

Hip Fracture Treatment As expected 42 C 25.8%

(25.2%)

11.9%

(22.6%)

66.7%

(58.5%)

21.4%

(18.9%)

Hip Replacement As expected 32 C 11.5%(10.7%) 18.8%(18.5%) 53.1%(63.0%) 28.1%(18.5%)

Total Knee Replacement As expected 40 C 10.1%

(10.1%)

20.0%

(23.8%)

62.5%

(51.9%)

17.5%

(24.3%)

Prostatectomy Service Line

Prostatectomy As expected 29 C 9.7%

(9.8%)

0.0%

(12.9%)

89.7%

(72.6%)

10.3%

(14.5%)

Pulmonary Service Line

Chronic Obstructive

Pulmonary Disease (COPD)

Worse than expected 56 M 1.8%

(1.4%)

1.8%

(6.5%)

78.6%

(80.3%)

19.6%

(13.2%)

Pneumonia Worse than expected 59 M 5.0%

(4.2%)

10.2%

(14.3%)

62.7%

(66.3%)

27.1%

(19.5%)

Vascular Service Line

Carotid Surgery Better than expected 23 C 10.2%

(12.7%)

34.8%

(16.8%)

60.9%

(66.9%)

4.3%

(16.3%)

Peripheral Vascular Bypass As expected 11 C 19.4%

(20.4%)

9.1%

(15.9%)

81.8%

(69.9%)

9.1%

(14.2%)

Resection/Replacement of

Abdominal Aorta


(3.6%)

0.0%

(5.6%)

93.8%

(86.6%)

6.3%

(7.8%)

Copyright 2012 Health Grades Inc All rights reserved

2013_HospitalQualityinSouthCarolinaReport

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