Medicare, in a push to improve hospital quality, identified 95 hospitals where older patients are more likely to suffer significant setbacks during knee and hip replacements and 97 hospitals where patients have the smoothest recoveries, the St. Louis Post-Dispatch in conjunction with Kaiser Health News reported.
Each year more than 600,000 Medicare patients have a hip or knee replacement, costing billions of dollars, leading the agency to analyze the two common elective procedures and publish the outcome data on the Hospital Compare website, the article states. Hospital Compare provides information about individual hospitals and Kaiser Health News published a table of the best and worst outliers from the research.
Medicare looked at how often patients were readmitted to the hospital within 30 days of discharge, as well as how often they experienced at least one in eight set complications, including heart attacks, pneumonia, sepsis or shock within seven days of admission. The agency also noted if patients experienced bleeding at the site of surgery, blood clots in the lung, death within a month of admission, and complications with implants or infection of the joint or wound within 90 days of admission, according to the article.
Nine hospitals in particular reported both high readmission and complication rates, according to the Post-Dispatch including Froedtert Hospital in Milwaukee, Wisc.; Grant Medical Center in Columbus, Ohio; Mercy St. Anne Hospital in Toledo, Ohio; Northwestern Memorial Hospital in Chicago; the Pennsylvania Hospital of the University of Pennsylvania Health System in Philadelphia; Peterson Regional Medical Center in Kerrville, Texas; Reston Hospital Center in Reston, Va.; Shannon Medical Center in San Angelo, Texas, and Southside Regional Medical Center in Petersburg, Va.
Beginning in 2014, Medicare penalties will include joint replacement, putting hospitals at risk to lose as much as 3 percent of their Medicare payments for each patient stay, according to the article.
However, hospitals claim the information Medicare used was outdated, covering operation results from July 2009 through June 2012, and that they've adopted new technologies and treatment models since that time, improving their patients' outcomes, the article states.
Of the 97 hospitals that scored better than average in avoiding readmissions or complications, there were 25 that bested both categories, the Post-Dispatch reported, including Sutter General Hospital in Sacramento, Calif.; the Hospital for Special Surgery in Manhattan; Holy Cross Hospital in Fort Lauderdale, Fla.; Arkansas Surgical Hospital in Little Rock and Barnes Jewish near St. Louis, Mo.
In 2012, a total knee replacement, including the initial hospital stay, related services, readmissions and post-acute care, cost an average of $22,611 for Medicare patients, compared to $25,872 for commercial patients, FierceHealthcare previously reported.