Hospital quality in the United States is good and is showing steady improvements over time. However, it still needs significant improvement with fewer than half of all hospitals achieving adequate quality standards. These findings were reported in the 2009 Leapfrog Hospital Survey that was lately released at the World Health Congress in Washington, DC.

The survey was completed by 1,244 hospitals. Many hospitals have shown significant improvements in their cardiac care. For example, 53.5% met Leapfrog’s quality standard for heart bypass surgery, compared to only 43% in 2008, while 44% of hospitals met the standard for heart angioplasty, compared to only 35% in 2008.

However, less than 50% of hospitals met Leapfrog’s outcome, volume, and process standards for six high-risk procedures and conditions. More specifically, of all the reporting hospitals:

• Only 11.8% met the standard for aortic valve replacement
• Only 36.1% met the standard for abdominal aortic aneurism repair
• Only 33.5% met the standard for pancreatic resection
• Only 31.5% met the standard for esophageal resection
• Only 36.6% met the standard for weight-loss (bariatric surgery)
• Only 29.9% met the standard for high-risk deliveries

Leapfrog CEO Leah Binder commented:

“There is significant improvement in performance, for which we commend hospitals as well as the hundreds of purchasers using Leapfrog data to improve quality of care for employees. Still, at most half of hospitals ever achieve acceptable standards for mortality, and that’s very concerning.”

Another major problem identified by the survey relates to “waste.” In terms of resource use for heart bypass surgery, for example, a 56% difference exists between the highest and lowest performing hospitals. For heart angioplasty, the difference is 79% between the highest and lowest performers. Resource use is measured using length of stay (number of days patient stays at hospital) as compared to readmission rates, since length of stay is a strong determinant of cost. These differences highlight the opportunities that exist for significantly cutting the costs of care for the lowest performing hospitals. According to Binder, "Employers and other large purchasers of care need to be assertive in demanding hospitals reduce this waste and improve their Leapfrog performance.”

The Leapfrog Group was founded in 1998 when a group of large employers came together to discuss how they could work together to use the way they purchased health care to have an influence on its quality and affordability. It is “a voluntary program aimed at mobilizing employer purchasing power to alert America’s health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded.” The survey is considered the gold standard for comparing hospitals’ performance on the national standards of safety, quality, and efficiency.

This post was included in the Health Wonk Review: NBA Playoffs Edition.