We think it is important for consumers to have access to hospital outcomes (deaths and complications), as well as other safety ratings, to provide them with the best available information from which to choose a hospital, affiliated physicians and participating health plans. Accordingly, we have taken a deep dive into the Centers for Medicare & Medicaid Services (CMS) data to develop a national rating system by comparing rates of death and complications for nearly 4,000 hospitals.
Hospital Outcomes: a Neglected Metric
“A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third leading cause of death in the United States…”[1] NPR.org May 3, 2016
“Death is the most important hospital outcome to avoid.”
We developed the Hospital Outcomes Scores (HOS) System to provide maximum transparency of hospital outcomes to healthcare consumers by focusing on death and complications because:
- Deaths are the most important outcome to avoid during a hospital stay.
- Death rates from serious treatable complications are much higher than all complications rates.
- Existing hospital ratings that are a blend of deaths, complications, procedures and other factors do not identify hospitals with superior outcomes (see below).
- Existing hospital ratings are not good predictors of death rates.
- HOS’s scale of 0% to 100% better differentiates among top performing (low death rate) hospitals than a letter grade or numerical scale of 1 to 5.
The new Hospital Outcomes Scoring (HOS) system is based on death and complication rates compiled by the Centers for Medicare & Medicaid Services (CMS) for all hospitals that have reported: 3,382 for complications and 3,962 for deaths.
Hospital Safety Grades & Outcomes don’t Correlate well
“As seen in the Figure (below), patients treated at hospitals receiving safety grades of D or F (n = 145) had slightly higher 30-day mortality for both medical and surgical admissions. …. Despite worse outcomes in hospitals with safety grades of D or F, the safety composite score did not discriminate outcomes in the remaining hospitals. Specifically, there was negligible difference in mortality or complication rates among hospitals receiving A, B, or C grades. There were no statistically significant differences across grades for readmission rates” from “Hospital Safety Scores: Do Grades Really Matter?” (emphasis added) by Andrew A. Gonzalez, MD, JD, MPH and Amir A. Ghaferi, MD 
Hospital Outcomes Scores
This short video (click on image) describes HOS and what it expected to accomplish.
Those of you who prefer an Adobe Acrobat document to a video, can click on this link:
Hospital Outcomes Scoring (HOS) Intro for Healthcare Professionals.
HOS is based on reported rates for 7 causes of death and 10 types of complications compiled by the Centers for Medicare & Medicaid Services (CMS) for over 4,000 U.S. hospitals. All death and complications rates are scaled from 0% (best) to 100% (worst) with a median of 50%. After scaling, all death rates are averaged together to provide a composite death rate, which is then re-scaled from 0% to 100%. Hospital complications rates are calculated similarly.
Hospital Outcomes Scores: Introduction & TOC
To obtain a complete copy of Hospital Outcomes Scores: Purpose, Methodology & Data Analysis, please contact us at paw@amoryassociates.com.
To try out our Interactive HOS State & Score Selector demo click on the image below:
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