On September 7th, 2007, the New York City Health and Hospitals Corporation (NYCHHC), the nation’s largest public health system treating 1.3 million patients a year, began publicly releasing data on infection and death rates at its 11 hospitals and 4 nursing homes.
The safety and performance information is posted on the hospital corporation’s Web site, www.nyc.gov/hhc. The Web site allows the public to see the overall death rate, the rate of deaths after heart attacks, preventable bloodstream infections and pneumonia cases, among other measures, at the 11 hospitals.
Information on the Web site also includes what the NYCHHC considers to be appropriate and timely treatment and prevention of heart attacks, heart failrue, pneumonia, central line infections, ventilator-associated pneumonia and surgical infections, and nursing home/long-term care issues such as pressure ulcers, pain management and preventing falls. This information is also presented in hospital and facility specific data.
Public reporting of other data, including a hospital’s mortality rate, is not required. The agency said it will update the data at least annually. List of NYCHHC hospital and nursing home facilities:
- Bellevue Hospital Center
- Coney Island Hospital
- Elmhurst Hospital Center
- Harlem Hospital Center
- Metropolitan Medical and Mental Health Center
- Coler-Goldwater Specialty Hospital and Nursing Facility
- Gouverneur Healthcare Services
- Jacobi Medical Center
- Lincoln Medical Center
- North Central Bronx Hospital
- Kings County Hospital Center
- Woodhull Medical and Mental Health Center
- Dr. Susan Smith McKinney Nursing and Rehabilitation
- Queens Hospital Center
- Sea View Hospital Rehabilitation Center & Home
The decision to make the data public was driven by Mayor Michael R. Bloomberg’s effort to make public health a centerpiece of his administration and by the hospital corporation’s recent focus on improving patient safety, and was made in response to widespread concern about deadly, preventable and costly hospital-acquired conditions and pressure to crack open the shrouded culture of many hospitals.puts the NYCHHC far ahead of the industry that has long resisted transparency.
Health experts and consumer advocates said hospitals had resisted making such data public – or even providing it to employees – in part because of concern that it would feed malpractice suits. A small but growing number of hospital systems and hospitals, including the Hospital for Special Surgery in Manhattan, have begun to voluntarily give consumers some information about quality of care that was closely held for years.
In 19 states, hospitals are required to report some information to the public about hospital-acquired conditions like bloodstream infections and bedsores. A law passed this year in New York requires hospitals to report rates of certain types of infections to the State Health Department, which will issue hospital “report cards” in 2009.
The federal Centers for Disease Control and Prevention projected that 1.7 million patients nationwide would get an infection during a hospital stay this year, and that of those, 99,000, or about 270 per day, would die. The centers estimate the cost of treating such infections at more than $30 billion a year. NYCHHC’s decision comes on the heels of this past August’s announcement by the Bush administration that Medicare would no longer pay the extra costs of treating preventable errors and conditions, tightening the pressure on hospitals to reduce infection rates.
NYCHHC President Alan Aviles warned that the data should be viewed with caution, and not used to pick one hospital over another. Some of the information released includes the following: You’re more likely to die at Coney Island Hospital than at other city-run hospitals – and more likely to catch pneumonia at Jacobi Medical Center, city statistics show.
Coney Island Hospital showed the highest death rate last year, at 3.14%, but also has a high number of elderly nursing-home patients. North Central Bronx Hospital had the lowest death rate, at .67%, but has a younger crop of patients. Overall, the mortality rate fell to 1.45% last year, down for the third year in a row, and lower than the latest national average, which was 2% in 2005. Heart attack patients were most likely to die at Elmhurst Hospital Center – 18% did – than at the other 10. The average mortality rate after a heart attack was 15.8% at HHC and 15.6% statewide.
Infections tied to central-line catheters or respirators were down last year overall, but there were wide disparities at the various facilities. No patients at Woodhull Hospital’s intensive care unit developed pneumonia last year during their stay, for instance, while at least one a month did at Jacobi’s ICU. 95% of the system’s heart-attack patients received timely treatment, including aspirin and beta blockers upon arrival, compared with a national average of 76.8%. The average for the New York City region was 78.6%. In 2006, however, the system had a slightly higher heart-attack mortality rate, 15.8%, versus 15.6% in New York State.
The system treated 88.1% of its pneumonia patients in a timely manner, which includes the distribution of antibiotics. That compares with 82.9% of New York City area patients receiving timely pneumonia treatment, and 81.6% nationally. The 11 hospitals prevented surgical infections 85.1% of the time, compared with 76% for the metropolitan area and 74.5% nationally. Infection rates tied to central line catheters were 5.4% in 2006, down from 7.6% the previous year.
The system also posted benchmark figures for its long-term and nursing home care in 2006. System patients suffered a pressure ulcer rate of 12%, compared with 14% in the state and 13% nationally. Patients experienced pain 13% of the time, versus 17% in the state and 22% nationally. Fall rates were 6.75% for the system, against 15.4% in the state.
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