Patients hospitalized for three common conditions--heart attack, heart failure and pneumonia--to an extent have better chances of survival if treated at larger, busier hospitals. Up to a threshold, researchers determined that hospital volume affected outcomes for those illnesses between 2004 and 2006, according to a study published in today's New England Journal of Medicine.
During that time, there were 734,972 hospitalizations for acute myocardial infarction, 1,324,287 for heart failure and 1,418,252 for pneumonia in more than 4,000 hospitals involved in the study. On average, the larger hospitals in the study treated 236 heart attacks, 422 heart failures and 405 pneumonia cases a year. Compared to smaller hospitals, the risk of death within 30 days of admission was 11 percent lower for heart attacks, 9 percent lower for heart failure and 5 percent lower for pneumonia.
However, researchers found that size no longer made a difference once hospitals treated 610 heart attacks, 500 heart failures and 210 pneumonia cases a year.
Furthermore, physicians caution that hospital volume is merely one factor patients should consider when choosing a hospital. "Size tends to matter, but there are differences even within large, medium and small hospitals" in their quality of care, Harlan Krumholz, MD, a Yale University cardiologist and one of the study's leaders, told the Associated Press.