SHOULD PATIENTS TRAVEL FOR ELECTIVE PROCEDURES?

November 28, 2016


Is it worth it for patients to travel a bit farther for elective procedures? For some surgeries, the answer is yes.

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Our 19th Annual Clinical Quality Report

The 2017 Healthgrades Report to the Nation examines patient complication and mortality risk for 32 common procedures across hospitals nationwide. We have evaluated the nation’s hospitals for 19 years, and clinical quality still varies dramatically.

As Healthgrades has consistently found, overall, patients have a dramatically lower risk of dying and experiencing complications at hospitals receiving a 5-star quality rating. For the 2013-2015 study period, patients had an average 71% lower risk of dying and a 65% lower risk of complications when treated at a 5-star hospital versus a 1-star hospital.

Managing Risk

Relative risk varies by procedure and by patients’ individual risk factors. For six common elective procedures, a patient’s relative risk of complications or mortality is significantly lower at a 5-star versus a 1-star rated hospital:

  • Cardiac bypass surgery: 86% lower risk
  • Hip replacement: 73% lower risk
  • Bariatric surgery: 72% lower risk
  • Total knee replacement: 67% lower risk
  • Hysterectomy: 60% lower risk
  • Pacemaker procedures: 57% lower risk

In addition, age, sex, medical history, and current health status (the presence of high blood pressure, diabetes, heart or lung disease, and kidney disease) will all affect a patient’s risk of complications.

Driving the Distance for Quality

The Report also revealed variations in patient access to quality care. In metropolitan areas, patients can often drive five miles or less to get to a hospital performing a given elective procedure. For example, in Omaha, Nebraska, over 84% of patients have access to a hospital performing pacemaker procedures within five miles of where they live. In Cleveland, Ohio, and Tampa, Florida, over 80% of residents can access hospitals performing hip and knee replacements by driving five miles or less. These statistics aren’t surprising, as 72% of Americans live within five miles of a hospital.

But the picture changes when clinical quality is factored into the equation. The hospital closest to a patient’s home may not perform the best for the care needed. To determine patient access to high-quality care, the Report evaluated patient distance from 5-star-rated hospitals for the six procedures above. In Cleveland, over 86% of people would need to drive more than 25 miles to access a 5-star-rated hospital for hip replacement surgery. Fully 100% of Tampa and Omaha residents would need to drive more than 25 miles to be treated at a hospital rated 5 stars for total knee replacement and pacemaker procedures, respectively.

What This Means for Your Hospital

These findings mean you can help your patients reduce their risk of surgical complications using multiple approaches. Healthgrades clients Virginia Mason Medical Center, Hospital for Special Surgery, and Palm Beach Gardens Memorial Center have all implemented the following strategies in unique ways to enhance patient outcomes.

  1. First: Identify individual risk factors, assist patients with managing modifiable risks, and determine surgical appropriateness.
  2. Second: Systematize the implementation and outcomes measurement of risk management programs.
  3. Third: Communicate your quality outcomes to patients in your immediate and extended communities.

As a top-performing hospital in a given procedure, expand your communications reach. Prospective patients near and far need to know they can improve their chances of a good surgical outcome by visiting a top-performing hospital for that procedure.

The 2017 Healthgrades Report to the Nation confirms that quality outcomes continue to vary widely. It also uncovers variability in patient risk and access to high-quality elective procedures.

Read more about client preoperative risk management strategies in the 2017 HealthgradesReport to the Nation.

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