HHS updates comparison data on imaging measures, heart readmissions

New information about the quality of care available in U.S. outpatient and emergency departments, including how well hospitals care for patients with heart attacks and protect outpatients from surgical infections, was added to the Department of the Health and Human Services’ (HHS) website.

The data, published on Hospital Compare, are based on claims for Medicare patients only. The website also includes 10 measures that capture patient satisfaction with hospital care. After two years of reporting satisfaction measures, hospitals have shown ”modest but meaningful improvement on most satisfaction measures,” HHS said.

On average, 1 in 3 Medicare beneficiaries receive an MRI scan of their lower back when they complain of pain, rather than trying more recommended treatment first, such as physical therapy, according to the Centers of Medicare & Medicaid Services (CMS). While most practitioners use imaging technology, such as MRI, safely and effectively to diagnose or treat disease, studies show that overusing MRIs for lower back pain could cause patients unnecessary stress, risk and cost.

The updated information includes data on the rates of outpatient MRIs for low back pain, outpatient re-tests after a screening mammogram, as well as two ratios that explain how frequently outpatient departments gave patients “double” CT scans when a single scan may be all that is needed.

Hospital Compare also includes new measures that show whether outpatients who are treated for suspected heart attacks receive proven therapies that reduce mortality such as an aspirin at arrival, and how well outpatient surgical patients are protected from infection. Previously, Hospital Compare had provided data only about the quality of care provided to hospital inpatients.

“Adding outpatient quality measures to Hospital Compare will give consumers a more complete picture of the quality of care available at local hospitals,” said Barry M. Straube, MD, CMS chief medical officer and director of the agency’s Office of Clinical Standards & Quality.  “In particular, the heart attack and surgical care outpatient measures can be viewed alongside the inpatient data we already report for these conditions, thus providing a comprehensive look at what facilities in your area are doing to provide high-quality, high-value care.”

In addition to outpatient care measures, CMS has updated data for outcomes of inpatient hospital care. The update includes new thirty-day mortality rates and thirty-day readmissions rates for inpatients admitted with heart attack, heart failure and pneumonia. These rates encompass three years of claims data (from July 1, 2006 to June 30, 2009).

This year, national 30-day mortality rates for heart attack have continued to decline, falling by 0.4 percent from the 2005-2008 rate of 16.6 percent to 16.2 percent. Mortality rates for heart failure and pneumonia readmissions stayed steady at 11.2 and 11.6 percent, respectively.

Also this year, national 30-day readmissions rates for heart attack, heart failure and pneumonia did not show remarkable changes from their 2005-2008 rates. The 2006-2009 rates for the three conditions are 19.9 percent, 24.7 percent and 18.3 percent, respectively. Both sets of inpatient measures are risk-adjusted and take into account previous health problems to “level the playing field” among hospitals and to help ensure accuracy in performance reporting,  according to CMS.

The information can be found as part of the Compare Care Quality link on the front page of the new website. It can also be found on CMS' Hospital Compare website.