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Compare hospitals on heart attack, heart failure and pneumonia

8-20-2008 National:

Welcome to a new era of openness in medical care.

In this interactive USA TODAY graphic, you'll find medicine's best-kept secret revealed: death rates for heart attack, heart failure and pneumonia for every hospital in the nation.

USA TODAY created this graphic using data compiled by the federal government's Center for Medicare and Medicaid Services (CMS). The agency also has supplied the information to the more than 4,000 hospitals included and posted them on a government website called Hospital Compare.

ON THE WEB: Compare hospitals in your ZIP code

STANDOUTS: Hospitals with highest and lowest death rates

USA TODAY has used the information to create an easy-to-navigate database that allows you to compare the performance of the hospital next door with the hospital across town. Want to check the performance of every hospital in your state? See the 100 hospitals that performed the best? The worst? We've put the information at your fingertips.

You can view the hospitals on a map, chart or several lists. When you click on a hospital, you'll see an estimate of the hospital's average death rate for one of the three conditions, bracketed by a high-end estimate or a low-end estimate. By presenting the information in this way, we can say with 95% confidence that the hospital falls in that range. We've included separate estimates for 2005-06 and 2006-07.

Underlying the calculations is a complicated "risk-adjustment" formula for ironing out differences in hospitals' patient mix, so the comparison will be fair.

The formula focuses on all deaths of heart attack, heart failure and pneumonia patients that occur within 30 days of a patient's admission to a hospital. If a patient is admitted more than once, one admission is randomly plucked out for analysis. CMS chose to include all deaths for any cause so that no death is missed that might be meaningful.

CMS picked 30-day mortality as its main benchmark of performance so it can include in the analysis patterns of deaths that might have escaped hospitals' notice because the patients didn't die until several days after they were discharged.

Finally, patients who were transferred from one hospital to another for more sophisticated care were credited to the first hospital. That's to avoid penalizing hospitals that receive the sickest patients. ..News Source.. by USA Today

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