When the U.S. Center for Medicare and Medicaid released the mortality rates for hospitals across the nation in July, the general public was able to access this once coveted information. Though the information was promoted as a way for patients to assess their local hospitals in comparison with others around the country, concerns have been raised about the processability of the information.Of the four Baton Rouge hospitals that submitted their 30-day heart attack mortality rates to the CMS, all four fell within the range CMS defines as “no different than the national average.” Of the 4,311 hospitals in the nation that submitted their records, only nine were rated as “better than the national average” and none fell into the range of “below the national average.”While the information provided by CMS seems useful for choosing a hospital at first glance, several local hospitals have voiced concern that the data can be misleading to consumers.One of the difficulties with interpreting the CMS data involves the range of patients investigated for the report. When CMS produced its comparisons, only Medicare recipients who had been in the Medicare program a full year were included. Patients who paid out of pocket or used private insurance were left out of the study.Erin Zeringue, director of quality control for Baton Rouge General Medical Center, said only a third of their 395 heart attack cases last year were Medicare recipients.”When we judge our performance, we don’t look at only a certain payer group, we look at our patient load as a whole” Zeringue said. “You can’t make an inference about mortality rates based on only a portion of patients.”For the hospitals caring for these Medicare patients, mortality rate is graded based on a 30-day time period starting when patients are admitted to the hospital. If a patient dies within these 30 days, regardless of the cause, it adds to the hospital’s death rate.”There are factors that contribute to mortality that consumers are not aware of,” Zeringue said. “If a patient is successfully treated, released and killed by a bus, it would still be counted.”Other factors, like a patient’s living will or previously existing medical conditions, are also excluded from the research regarding heart attack mortality.When hospitals submit their patient records to Medicare, they must take care to properly record a patient’s prior medical state. CMS uses only the patient’s Medicare history when the person arrives at the hospital, a record medical professionals acknowledge may be incomplete or inaccurate.”If I did not do a good job listing the patient’s illnesses that might increase the likelihood of death, the risk adjusted mortality would be distorted,” said Dr. Richard Vath, chief medical officer at Our Lady of the Lake Regional Medical Center.When USA Today released its 100 highest and lowest hospital death rates in the nation, Baton Rouge General found itself on the less prestigious list. Though the list was created based on CMS numbers, even those can be misleading, local hospital officials said.The numbers for Baton Rouge General might suggest it belongs on the list, but the hospital is not statistically different from the rest of the hospitals in the nation.”Because there is no statistical significance, it isn’t good information for consumers,” said Scott Miller, marketing manager for Baton Rouge General.Large scale statistical analysis adjusts results based on the possibility that variations are the result of random chance. Statistical significance identifies true conditions that fall outside the random chance window and these are stronger indicators of true differences. Despite difficulties with the information on a consumer level, feedback from medical professionals regarding the USA Today article has been mostly positive. “We have not had one word of criticism,” said Steve Sternberg, the USA Today reporter primarily responsible for the article. “The information is rock solid.” In a past article, the Daily Reveille reported on the changes in heart attack mortality rates without accounting for variables which could alter the reliability of the data. Statistically, all four hospitals in Baton Rouge — Baton Rouge General Medical Center, Earl K. Long Medical Center, Our Lady of the Lake Regional Medical Center and Ochsner Medical Center Baton Rouge — fall within the national average for mortality rates.Though the CMS data can be difficult for the average consumer to process, it represents an important move in the medical field toward transparency for patients.”It’s not a completely bogus measurement,” said Vath. “I think it helps hospitals look at themselves and how well certain variables of health care are being considered.”Hospitals around the country are using this information to compare themselves with other national medical facilities, according to Vath. Medicare is looking to identify the nation’s best performers and to reduce variation from hospital to hospital.—-Contact Adam Duvernay at [email protected]