Patients’ Hospital Ratings Correlate with 30-Day Mortality and Readmission Rates following Hospitalization for Both Myocardial Infarction and Coronary Artery Bypass Graft Surgery

Abstract

Introduction: Coronary heart disease is the leading cause of mortality and morbidity world-wide. Mortality and readmission rates following both myocardial infarction (MI) and coronary artery bypass graft surgery (CABG) have improved with advancements in medicine and standardization of treatment, however these improvements have plateaued in recent years. The purpose of this study was to investigate whether overall hospital ratings can indicate patterns of mortality rate and readmission rate following hospitalization for MI and CABG. Methods: Public data from the Centers for Medicare & Medicaid Services was utilized in the study. The 30-day risk standardized mortality rate (RSMR) and readmission rate (RR) following both MI and CABG for hospitals were matched with their overall hospital rating based off the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Hospitals were grouped based on their hospital ratings and their 30-day RSMR and RR were averaged within each group. A Pearson correlation was used to assess for correlation between hospital ratings and their 30-day RSMR and RR for both MI and CABG. Results: There was a strong negative correlation between hospital ratings and their averaged 30-day RSMR for both MI (R= -0.84; P < 0.0001) and CABG (R = -0.70; P < 0.0037). Similarly, there was a strong negative correlation between hospital ratings and their averaged 30-day RR for MI (R = -0.81; P < 0.0002) and CABG (R = -0.83; P < 0.0001). There was no significant difference between any group. Discussion: The correlation between hospital rating and the 30-day RSMR and RR following both MI and CABG suggest that hospital ratings may be one among many factors that can impact patient outcome for MI and CABG. However, this correlation is only present when the 30-day RSMR and RR are averaged. There are likely multiple confounding variables and improving hospital ratings alone would not be expected to significantly improve patient outcomes. Conclusion: Hospital ratings which incorporates patients’ perspective of good communications among hospital staff, timely staff responsiveness, quiet/clean hospital environment, and thorough discharge planning, may be factors that contribute to patients’ 30-day RSMR and RR for both MI and CABG.