L.A. County Questions Mortality Data
In matters of patient mortality, it's one health department's word against another's.
That was the case when the Los Angeles County Department of Health Services this week questioned mortality data released earlier this week by the Office of Statewide Health Planning and Development concluding its L.A. County-USC Medical Center had higher than average mortality rates in more categories of care than any other hospital in California.
County-USC scored worse than average mortality rates in five of 12 categories: craniotomies, percutaneous coronary prevention, heart attacks, heart failure, and acute stroke. For percutaneous coronary prevention and heart attacks, County-USC's mortality rate was more than double the statewide averages of 2.3% and 6.5% respectively, clocking in at 4.9% and 13.4%.
No other hospital among the 331 surveyed statewide reported worse than average mortality rates in more than three categories. Most with any below-average mortality rates reported them in just one or two categories. The metrics were developed by the federal Agency for Healthcare Research and Quality and adopted by OSHPD.
Officials with the L.A. County DHS insisted that the data OSHPD used in its case was riddled with coding errors, which may have caused confusion in the data.
“After correcting for these coding errors, LAC+USC Medical Center’s observed mortality data is consistent with or better than expected mortality rates,” said DHS spokesperson Michael Wilson. He added that his agency “is actively focusing on improving the accuracy and comprehensiveness of medical coding and expects to see improvements in publicly reported data in the future as coding practices improve.”
Wilson also noted that the data was gathered in 2011, and that the hospital has improved its quality of care in the intervening years.
OSHPD said the mortality data was risk-adjusted to take into account patient acuity.
Several other facilities that received a below-average indicator took issue with OSHPD in comment letters filed with the agency. They claimed their case mix was too severe to be compared with other hospitals.
Altogether, 69 hospitals received worse-than-average mortality ratings for at least one procedure, which also included repairs to aortic aneurysms, hip fractures, and pneumonia. Nineteen hospitals received two worse-than-average scores, and five received three subpar scores.
Forty-six hospitals received above-average scores in one indicator, 15 in two categories, and four in three categories.
One hundred and eighty-three hospitals received averaged overall ratings.
“These reports are part of a larger effort to make healthcare more transparent and accountable in California,” said OSHPD Director Robert P. David. “We encourage hospitals to review their reports closely for any opportunities to improve the care they provide.”
