Holy Cross Hospital and Utah Valley Regional Medical Center are among 102 hospitals nationally that have death rates significantly higher than statistics would predict.

And Sevier Valley Hospital in Richfield almost made that list, which is based on death rates for Medicare patients older than age 65. It was released Wednesday by the U.S. Health Care Financing Administration, which oversees Medicare."This information makes it very clear that something is going on here, that there is a quality problem," said William Toby, acting administrator for the agency.

However, the agency is also quick to say that such death rates are only one of many measures of hospital quality - and that hospitals with higher-than-expected rates are not necessarily bad.

The new study showed that 29 of 34 hospitals in Utah that treated more than 50 Medicare patients in 1990 had death rates within expected ranges for the number and types of patients they received, based on two complicated statistical tests that the government used.

But Holy Cross and Utah Valley hospitals were worse than expected according to both statistical measures, which placed them on the list of 102 questionable-care hospitals.

Sevier Valley failed one statistical test and almost failed the other. And LDS, Alta View and San Juan (of Monticello) hospitals failed at least one such test for death rates at either 30 days or 180 days after admission - but were within acceptable ranges based on the other statistical measure.

The study also said that Medicare patients in Utah overall had higher-than-expected death rates. The actual death rate 30 days after admission was 8.6 percent - or 16 percent higher than the 7.4 percent predicted based on patients' age, diseases and previous hospital admissions.

The death rate at 180 days after admission was 15.4 percent - or 10.8 percent higher than the 13.9 percent predicted.

Those rates were lower than the national average. The average actual and predicted death rate at 30 days after admission was 9 percent. At 180 days after admission, the actual rate was 17.3 percent - or slightly higher than the 17.1 percent predicted.

Of the 39 hospitals in the state that treated Medicare patients in 1990, 28 had death rates higher than predicted (although most were within acceptable ranges) and 11 had rates lower than predicted.

The study also showed that death rates were generally higher-than-expected in hospitals along the heavily populated Wasatch Front, and were lower-than expected in rural areas - which government officials have said could be because the most sick patients are transferred to the urban hospitals.

The death rate 180 days after admission in rural Utah areas was 14.9 percent, or less than the 15.3 percent expected.

In the Salt Lake City-Ogden area, the same rate was 15.5 percent - more than the 13.6 percent predicted.

In the Provo-Orem area, the rate was also 15.5 percent, which was also more than the 13.2 percent predicted there.

The government said it released the information to help consumers ask questions about the care they receive, and especially ask hospitals with lower marks about their care. "This is an educational tool, not an instrument for punishment," Toby said.