Medicare Sizes Up Hospital Heart-Attack Care

Medicare has just launched a Web site that allows users to compare U.S. hospitals. Called "Hospital Compare," the Web site looks at how often a hospital provides recommended care to patients being treated for heart attack or heart failure. The measures are based on data from patient records collected since 2004.

I gave the site a test drive, opting to compare hospitals in the Washington, D.C., metropolitan area. I restricted the search to a 10-mile limit and selected information regarding heart attacks. But the Web site doesn't give an overall rating for heart attacks to allow for broad comparisons among hospitals. Instead, each hospital is given eight separate ratings. Those measures of care are known to be effective for most adults who've had a heart attack.

For instance:

Aspirin on Arrival

Taking aspirin as soon as symptoms of a heart attack begin is thought to help reduce the severity of the attack. Medicare reports that 92 percent of heart attack patients in the United States are given aspirin within 24 hours of arrival. The hospitals I selected in Washington, D.C., reported a range of 94 percent to 98 percent of patients. With percentages this high, comparisons aren't really useful.

Opening Blocked Blood Vessels

Some of the most effective procedures to open a blocked blood vessel, increase blood flow, and prevent further damage to the heart are called percutaneous coronary interventions (PCI). The three procedures commonly referred to as PCI are angioplasty (a balloon is inserted via a catheter and inflated to widen a constricted blood vessel), stenting (a small wire tube is placed in the blood vessel to hold it open), and atherectomy (a blade or laser removes the blockage).

The hospitals I selected had treated fewer than 25 eligible patients – not enough to reliably predict hospital performance. But by clicking on a link to a table, I could see the actual numbers of patients treated with PCI per hospital.

Mortality Rates

Death rates are given within 30 days of hospital admission for heart attack or heart failure. Thirty days is the time period when deaths are most likely to be related to the care patients received in the hospital. These rates include deaths while still in the hospital or after discharge.

However, for the vast majority of hospitals (4,453 out of 4,477), rates are no different from the national average. Unless you happen to be looking at one of the 24 hospitals in the country that are above or below the national average, this option doesn't really help a person choose between hospitals.

Experts Weigh In

Johns Hopkins Medicine said in a statement that Medicare's Hospital Care Web site is a good first step, although "data is restricted to Medicare patients only, ages 65 and older, and conclusions specific to this group alone may not apply to the general population."

Dr. Howard Herrmann, a cardiology director at the University of Pennsylvania, stresses that the most important thing for heart attack victims is to get to medical care as quickly as possible. That means choosing the closest hospital.

He says the site does help identify the small number of problem hospitals. But he says the site has a far more useful service. By publishing performance statistics, Medicare is publicly holding hospitals accountable and putting pressure on them to improve.