NCPA - National Center for Policy Analysis


September 28, 2006

Heart patients in wealthier communities have a better chance of getting recommended treatments at their local hospitals than patients in lower-income areas, according to a Gannett news Service analysis of how frequently U.S. hospitals gave recommended treatments to those suffering from heart attacks and heart failure found that the best-performing hospitals are much more concentrated in the nation's higher-income counties.

According to researchers:

  • In low-income counties, top-performing hospitals are scarce; in counties ranking in the lowest 20 percent for median household income, only 5 percent of the hospitals were in the highest of five performance rankings for heart attack patients; nearly half of them fell into the lowest category.
  • In high-income counties, a quarter of the hospitals were top performers.

In addition to the household income of a hospital's home county, there were other powerful indicators associated with hospital performance.

Medical school affiliation:

  • This makes a dramatic difference in following guidelines, particularly for heart attack patients.
  • Among larger teaching hospitals, those with 500 beds or more, more than a third earned top ratings for heart attack treatments; very few of those facilities (3 percent) were in the lowest performance category.

Urban vs. rural:

  • Only about one in nine rural hospitals fell into the top-scoring category for treating heart attack patients.
  • More than a third were in the lowest category; urban hospitals were unlikely to be in the lowest category, with about 13 percent.
  • For heart failure patients, nearly a third of rural hospitals fell into the lowest performance category.


  • On average, hospitals in Southern states provided standard treatments for heart attack patients about 87 percent of the time.
  • In other regions, the average was more than 90 percent.

Source: Robert Benincasa and Jennifer Brooks, "Best cardiac care found in wealthiest areas, GNS analysis shows," Gannett News Service/USA Today, September 27, 2006.

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