Low-volume hospitals increase mortality risk

Low-volume hospitals are less prepared for common surgical procedures, putting patients at risk for serious harm, according to an analysis by U.S. News & World Report.

U.S. News studied every U.S. hospital that treated or operated on fewer than 25 traditional Medicare inpatients for several common conditions and procedures. The publication found that knee-replacement patients at these hospitals had twice the mortality risk and a 25 percent increased risk for readmission due to postoperative complications.

For example, at Colorado's Sterling Regional Medical Center, a 25-bed facility that admits more than 1,200 patients annually, the mortality rate was 24 times the national average for knee replacements and three times the national average for hip replacements, according to the analysis.

John Birkmeyer, M.D., executive vice president for enterprise services and the chief academic officer ‚Äčat Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, used the publication's data and projected that up to 11,000 deaths in the 2009-2012 period could have been averted if patients at the lowest-volume 20 percent of hospitals had gone to the highest-volume 20 percent instead. Birkmeyer noted that his calculations only applied to five of the most common conditions and procedures, and that expanding it to the full range of common conditions and procedures would show tens of thousands of preventable deaths.

U.S. News conducted the analysis as part of a new set of rankings of hospitals for common procedures. The research found similar outcomes proportional to volume at hospitals larger than Sterling. For example, 331-bed Lawnwood Regional Medical Center & Heart Institute in Ft. Pierce, Florida, carries a relative mortality risk after a hip replacement nine times the national average, and New Jersey's 316-bed Jersey City Medical Center had mortality risk four times the national average for heart bypass surgery.

A 2013 study recommended closing or consolidating low-volume providers as a method of improving outcomes and care quality, FierceHealthcare previously reported. Moreover, research indicates emergency department patients at high-volume EDs have a lower risk of death.

To learn more:
- read the analysis

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