Thomson Reuters selects 15 top-performing health systems

Thomson Reuters, in its fourth annual study identifying the top U.S. health systems based on balanced system-wide clinical performance, has culled data from more than 300 organizations to single out 15 hospital systems that achieved superior clinical outcomes based on a composite score of eight measures of quality, patient perception of care and efficiency.

"This year we are seeing stronger system-wide performance and increased rates of improvement, particularly among the 15 Top Health Systems award winners. Health system performance is beginning to reflect aspirations to provide more consistent outcomes across communities served," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals program at Thomson Reuters. "Healthcare reform appears to have stimulated the increased rate of improvement at the system level."

Among the key findings in the study were the following:

• Lower 30-day mortality rates: 15 Top Health Systems held post-discharge 30-day mortality rates steady, while peer health systems demonstrated a significant increase in post-discharge mortality.
• Better survival rates: Winning hospitals had 17 percent fewer deaths than expected considering patient severity, while non-winning hospitals had 4 percent more deaths than expected.
• Fewer complications: Patients of the winning health systems had 19 percent fewer complications.
• Shorter hospital stays: Patients treated in the winning system hospitals had a median average length of stay of 4.7 days, nearly half a day shorter than their peers' median of 5.1 days.
• Better patient safety and core measure adherence: Top health systems had 23 percent fewer adverse patient safety events than expected and had better adherence to core measures of care than their peers.

The study divided the top health systems into three comparison groups based on total operating expense of the member hospitals. The winners are as follows:

Large Health Systems (more than $1.5 billion total operating expense)

• Banner Health in Phoenix;
• CareGroup Healthcare System in Boston;
• Jefferson Health System in Radnor, Pa.;
• Memorial Hermann Healthcare System in Houston; and
• St. Vincent Health in Indianapolis.

Medium Health Systems ($750 million-$1.5 billion)

• Baystate Health in Springfield, Mass.;
• Geisinger Health System in Danville, Pa.;
• HCA Central and West Texas Division, Austin, Texas;
• Mission Health System in Asheville, N.C.; and
• Prime Healthcare Services in Ontario, Calif.

Small Health Systems (less than $750 million)

• Baptist Health in Montgomery, Ala.;
• Maury Regional Healthcare System in Columbia, Tenn.;
• Poudre Valley Health System in Fort Collins, Colo.;
• Saint Joseph Regional Health System in Mishawaka, Ind.; and
• Tanner Health System in Carrollton, Ga.

U.S. health systems with two or more short-term, general, non-federal hospitals; cardiac and orthopedic hospitals; and critical access hospitals were assessed in the study. Researchers looked at eight metrics that gauge clinical quality and efficiency: mortality, medical complications, patient safety, average length of stay, 30-day mortality rate, 30-day readmission rate, adherence to clinical standards of care (evidence-based core measures published by the Centers for Medicare & Medicaid Services) and HCAHPS patient survey score (part of an initiative sponsored by the U.S. Department of Health and Human Services to measure the quality of care in hospitals).

The study relied on public data from the 2010 Medicare Provider Analysis and Review and the CMS Hospital Compare datasets.