NCPA - National Center for Policy Analysis


August 25, 2005

Doctors and hospitals fail with alarming frequency to deliver essential lifesaving treatments for some of the most common causes of death: heart attack, pneumonia and heart failure, says the New York Times.

Statistics gathered by the federal government under a provision of the 2003 Medicare prescription drug law represent the first time all hospitals have publicly reported performance data. More than 3,500 hospitals are participating in the program, called Hospital Compare, in exchange for a bonus in Medicare payments. Consider:

  • Patients who take aspirin in the first 24 hours after a heart attack have a 30 percent increase in survival, yet hospitals neglected to give aspirin to more than 12,000 people -- one of every 16 heart attack victims -- in the first half of 2004.
  • Beta blockers also give big survival benefits, but one in eight patients who should have received them did not.

The report cards also show wide variation from state to state, as well as hospital to hospital.

  • Massachusetts led the states in basic heart attack care, delivering the appropriate therapy 97 percent of the time; other New England states also performed better than most, as did some in the Northern Plains, like Minnesota and Montana.
  • Arkansas was last, with 85 percent compliance, with Hawaii and Nevada close by; Southern and far Western states tended to do less well on heart care measures.
  • At the hospital level, variation was wider; some hospitals had 100 percent compliance, but some were at 50 percent.

Some hospital officials say they tried to improve on quality measures before 2004, but acknowledge they are now getting more attention from their doctors. The Times says hospitals that did best realized they had problems, and systematically set out to fix them with checklists, patient safety rounds, even firings of administrators.

Source: Ford Fessenden, "It's the Simple Things, but Some Hospitals Don't Do Them," New York Times, August 21, 2005.

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