While the Medicare report is not intended to be "an instrument for punishment," hospital administrators complain that the statistics are an unfair consumer guide in choosing a hospital.
"After being completely cured of cancer, a patient could get in a car accident on the way home from the hospital and the death would show on hospital record in this report as a mortality," Larry Dursteler, administrator of the Utah Valley Regional Medical Center, told the Deseret News."Or someone may be admitted to the hospital with a heart problem and a myriad of additional complications - and die. But the death would have nothing to do with the quality of care the patient has received. Physicians could have done everything perfectly and the death would be counted against us," he said.
Dursteler contends the report is not a measure of the quality of care patients receive at Utah Valley, which received a poor rating on the government study. "We have numerous quality review programs which evaluate and ensure the best possible care. Patients have no need to worry at all about the treatment they receive here."
Furthermore, Utah Valley is a tertiary care hospital, with specialists treating very ill patients from throughout the region. "If a patient shows up with cancer in Richfield, then he is sent here. Because we receive patients from everywhere, there are demonstratively more ill to begin with."
Holy Cross Hospital officials argue that there are discrepancies in how the data is collected and reported nationwide. The Salt Lake hospital was listed as having a high mortality list.
Robert W. Ladenburger, president of Holy Cross Hospital, said Wednesday that in reviewing the data he found that the number of nursing home and emergency patients admitted to his hospital was inaccurately reported. Additionally, the report includes mortality rates of patients more than 180 days after they have been discharged from the hospital "who may have died of causes totally unrelated to their hospitalization," he said.
"We believe that adjustments in these areas would show that Holy Cross compares favorably with other area hospitals. Quality of care is very much a part of our mission and our reputation," he said.
Holy Cross Hospital Acting President Dale Austin stated that "adjustments for differences in patient mix and severity continue to mislead consumer and to leave hospitals questioning the validity and design" of the report.
Joining the two hospitals in criticizing the Medicare report, the Utah Hospital Association states that "survival rate" is only part of what constitutes quality medical care.
"We would expect to find some of the larger tertiary hospitals that treat patients with more advanced stages of illness to have higher mortality rates," said Utah Hospital Association President Richard B. Kennersley.
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(Chart)
Utah Medicare patient death rates
Actual death rates and predicted death rates compared 30 days and 180 days after hospital admission.
Percent of total
Number of 30 days 180 days
Hospital cases actual predicted actual predicated
Allen (Moab) 81 12.3 8.1 18.5 15.6
Alta View 439 11.2 7.8 19.8 14.0
American Fork 634 7.1 6.8 13.7 12.7
Ashley Valley (Vernal) 250 6.0 9.2 12.8 16.4
Bear River (Tremonton) 50 14.0 9.1 22.0 16.5
Beaver Valley (Beaver) 118 5.9 7.7 11.9 14.5
Brigham City 264 10.6 8.3 14.8 14.3
Castleview (Price) 490 9.2 10.3 16.3 17.5
Central Valley (Nephi) 128 11.7 9.9 17.2 17.5
Cottonwood (Murray) 1,385 9.5 7.9 16.0 14.2
Delta 63 6.3 6.2 15.9 12.3
Dixie (St. George) 1,524 8.5 8.3 14.8 15.1
Doxey Hatch (Salt Lake) 20 15.0 5.3 35.0 10.0
Duchesne County
(Rooselvelt) 140 9.3 8.2 15.0 15.3
Fillmore 59 15.3 9.0 22.0 16.3
Garfield (Panguitch) 120 7.5 6.6 13.3 12.7
Gunnison Valley 189 8.5 12.4 13.2 20.9
HCA St. Marks (S.L) 2,101 9.1 7.6 15.6 14.1
Holy Cross (S.L) 2,470 8.9 5.4 16.4 11.4
Human Davis North
(Layton) 599 7.5 8.2 15.0 14.6
Kane County (Kanab) 71 5.6 9.6 14.1 18.2
Lakeview (Bountiful) 728 10.9 10.2 18.8 17.1
LDS (Salt Lake) 4,092 6.9 5.7 13.9 11.9
Logan 1,213 6.8 8.3 12.8 14.5
McKay-Dee (Ogden) 2,321 8.1 7.7 14.2 14.3
Milford 47 10.6 8.2 17.0 15.3
Monument Valley 33 3.0 9.1 3.0 17.1
Mountainview (Payson) 774 8.1 6.2 13.0 11.4
Orem 46 2.2 4.5 4.3 8.5
Pioneer Valley (W.V.) 748 7.8 8.9 16.0 15.6
San Juan (Monticello) 74 16.2 11.4 32.4 21.0
Sanpete (Mt. Pleasant) 76 9.2 8.3 14.5 15.2
Sevier Valley
(Richfield) 201 11.4 5.9 17.4 11.5
St. Benedicts (Ogden)1,392 9.3 8.1 18.1 15.9
Tooele 166 14.5 10.6 19.3 18.0
University of Utah 1,526 6.7 7.0 14.8 14.1
Utah Valley (Provo) 2,533 10.7 7.4 16.8 13.9
Valley View
(Cedar City) 246 9.3 6.8 13.0 11.9
Wasatch County (Heber) 131 11.5 8.4 18.3 14.2
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Utah State Totals 27,546 8.6 7.4 15.4 13.9
National Totals 6,542,299 9.0 9.0 17.3 17.1
Source: U.S. Health Care Financing Administration