Choice of Hospital May Save Your Life

A recent study shows that patients are more likely to survive an acute heart attack or stroke if they are treated at a top-rated hospital.

Patients with an acute heart attack who were treated at a hospital ranked in the top five percent of U.S. hospitals had a 30-day mortality rate of 15 percent, compared with 20 percent for patients treated at hospitals ranked in the lowest 25 percent of hospitals. If these differences seem small, keep in mind that they represent one additional death for every 20 patients admitted to a bottom-rated rather than to a top-rated hospital.

Among patients admitted for heart failure, the 30-day mortality rate was 10 percent at top-rated hospitals compared with 14 percent for the low-rated hospitals.

These findings don't surprise me when the hospital rankings are based on experience and expertise of their staff, availability of special equipment and procedures, and the number of patients treated.

This information may not help patients in less populated regions whose only choice in a medical emergency is to go to their local hospital. Even in a large metropolitan area with a number of hospitals, ambulances generally take acutely ill patients to the closest hospital, not the one with the highest rating.

If you have a choice of hospitals, however, you should become familiar with the rankings of the available hospitals and decide where to go for treatment of a life-threatening condition based on these rankings, not the quality of the food or whether family and friends can find free parking. That's certainly what I would do.

Another value of such studies is the recognition that patients benefit most as the quality of hospital staff and patient care continue to improve at all hospitals, as it already has over the years. About 35 years ago, the 30-day mortality after an acute heart attack was as high as 30 percent even in the very best hospitals.