Patients treated at hospitals with high quality scores fare only slightly better than those treated at the lowest-ranked hospitals, according to a study published this week in the Journal of the American Medical Association.

University of Pennsylvania School of Medicine researchers examined 2004 data from 3,657 hospitals, comparing performance on Medicare-mandated quality measures and mortality rates for patients being treated for heart attack, heart failure, and pneumonia.

While patients at hospitals that scored high on quality measures fared better than those at hospitals who scored low, the statistical significance was minimal. For example, the absolute reduction in risk-adjusted death rates for heart attack patients was 0.005 for inpatient death, 0.006 for 30-day death, and 0.012 for death at one year. The figures were similar for patients with heart failure and pneumonia.

These results highlight the need for more meaningful quality measures. “Our study suggests that in the case of hospital performance, the CMS’s current set of performance measures are not tightly linked to patient outcomes. These findings should not undermine current efforts to improve health care quality through performance measurement and reporting,” the study authors wrote. “However, attention should be focused on finding measures of health care quality that are more tightly linked to patient outcomes. Only then will performance measurement live up to expectations for improving health care quality.”

The article is available to subscribers online at http://jama.ama-assn.org.

Contact: Sandra Bressler, 415/882-5171 or sbressler@cmanet.org.