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MORTALITY: US hospital mortality rate 1.89 percent in 2013

Data from the Healthcare Cost and Utilization Project (HCUP) are available on a great free online site that you can use to run state and national statistics on hospital utilization and cost by patient diagnosis or procedures.  It’s a collection of databases, which separately address the hospital inpatient setting, children in the hospital inpatient setting, the emergency department, readmissions, and state-specific data.

Recently, a caller to the AHA Resource Center asked for a national average for HOSPITAL MORTALITY RATE.  I decided to see what could be found on this in HCUPnet.  The following data are from the National Inpatient Sample (NIS) on HCUPnet.  Another nice feature of this database is that it contains all-payer data – not limited to Medicare data.

  • 1.89 percent (672,510 inhospital deaths based on records for 35.6 million discharges) in 2013

It is easy to re-do the same query on earlier years, so I did.  The results are consistent for the five most recent years (see below).  Likewise, the number of total discharges contained in each year of the data are consistent – at about 36 to 37 million.

U.S. Hospital Mortality Rate Trends: Most recent 5 years

  • 1.89 percent (2013)
  • 1.84 percent (2012)
  • 1.87 percent (2011)
  • 1.86 percent (2010)
  • 1.89 percent (2009)

Going back to the earliest available year – 1997 – the mortality rate was 2.45 percent.

Source: U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality.  HCUP national (nationwide) inpatient sample.  Click here: http://hcupnet.ahrq.gov  Posted by AHA Resource Center (312) 422-2050, rc@aha.org



EMERGENCY DEPARTMENT: What is a warm handoff?

Reading Hospital (West Reading, PA) implemented a program in early 2016 referred to as a “warm handoff” intended to help patients who present in the emergency department with heroin or other opioid addiction.  The idea is to first care for whatever caused the patient to come to the ED and then connect the patient with a substance abuse treatment program.  If the patient is interested in accepting the warm handoff, the ED staff makes a connection to appropriate mental health staff.

The hospital website indicates that the Reading Hospital is one of the busiest EDs in Pennsylvania, with over 107,000 ED visits per year.  The warm handoff program is currently operating at about one patient every two days … so 182 warm handoff patients per year, by my calculation.  Or, 182 patients/107,000 visits = 170 warm handoff patients/100,000 ED visits, again by my calculation.


Sandel, K. (2016, May 18). What is the ‘warm hand-off’ and how can it help Pennsylvania’s opioid abuse crisis? Pennsylvania Medical Society Quality and Value Blog. https://www.pamedsoc.org/tools-you-can-use/topics/quality-and-value-blog/BlogMay1816

Warm handoffs connect substance abuse patients to vital services. (2016, Oct.). ED Management, 28(10), 118-119. Click here for publisher website: https://www.ahcmedia.com/articles/138640  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

MRSA: 1.2 percent of hospital stays in California (2013)

In 2013, there were over 3.1 million inpatient stays in California hospitals, according to the California State Inpatient Database – which includes information on patients of all ages.  This study examines characteristics of those patients who had a hospital stay associated with Methicillin-resistant Staphylococcus aureas (MRSA).  Here are some of the findings:

  • 1.2 percent of California hospital stays involved MRSA
  • 1 in 100 California hospital stays involved MRSA
  • Over 40 percent of the MRSA was associated with cellulitis or skin ulcers
  • Only 8 percent of hospitalized patients with MRSA acquired their MRSA in a hospital
  • Another 41.9 percent of hospitalized patient with MRSA acquired their MRSA in the community after contact with some type of health care facility

Source: Sutton, J.P., and Steiner, C.A. (2016, Oct.). Hospital-, health care-, and community-acquired MRSA: Estimates from California hospitals, 2013. Healthcare Cost and Utilization Project Statistical Brief, 212.  Click here: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb212-MRSA-Hospital-Stays-California-2013.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

CANCER: Childhood and adolescent death rate declining

The cancer death rate among children and adolescents declined between 1999 and 2014, according to this data release from the U.S. National Center for Health Statistics.  The mortality rate for cancer patients (aged between 1 and 19 years) was 2.28 deaths per 100,000 persons in 2014, which was 20 percent lower than in 1999.

What types of cancer are the major causes of death for this age group?

  1. Brain (30 percent)
  2. Leukemia (25 percent)
  3. Bone and related (10 percent)

Source: Curtin, S.C., Minino, A.M., and Anderson, R.N. (2016, Sept.). Declines in cancer death rates among children and adolescents in the United States, 1999-2014. NCHS data brief, 257. Click here for free full text: https://www.cdc.gov/nchs/data/databriefs/db257.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

RESEARCH: Takes 17 years to translate to clinical practice

This is a brief interview with Andrew B. Bindman, M.D., the director of the federal Agency for Healthcare Research and Quality (AHRQ) about recent threats to the agency’s federal funding and program priorities.  Dr. Bindman mentions that one priority is to shorten the lag time that it takes for research evidence to be disseminated into use in clinical practice.  One approach is a program called EvidenceNOW that provides coaching to primary care physicians in small practices.  Another uses telemedicine and a hub-and-spoke approach to connect specialists and PCPs.  Dr. Bindman also mentions a new Comparative Health System Performance initiative intended to compare the organizational performance of multi-institutional health systems.

Source: Stephenson, J. (2016, Sept. 30). AHRQ director sets course for agency’s health services research. JAMA.  Click here: http://jama.jamanetwork.com/article.aspx?articleid=2565313   Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Physician Practice Acquisition and Employment Trends

A new report by the Physicians Advocacy Institute (PAI) in collaboration with Avalere Health analyzes recent trends in physician employment and the acquisition of physician practices by hospitals and health systems. Physicians may become employees through a group practice acquisition, or individual physicians may enter into employment arrangements directly with hospitals/systems. Here are some highlights from the analysis:

  • Between July 2012 and July 2015, the percentage of hospital-employed physicians increased nearly 50%
  • By 2015, 38% of physicians were employed by hospitals
  • Hospital or system ownership of physician practices grew by 86% from 2012 to 2015
  • By July 2015, there were 67,000 hospital-owned physician practices
  • One in four physician practices was hospital-owned by 2015

Regionally, nearly half of all physicians in the Midwest were employed by hospitals in 2015. Physician employment rates were lowest in the South and in Alaska and Hawaii where a third of physicians were hospital-employed. The pros and cons of these employment trends are briefly listed.

PAI and Avalere are planning additional analysis of this trend and its implications for early 2017.


Source: Avalere Health. Physician practice acquisition study: national and regional employment changes. Physicians Advocacy Institute, Sept. 2016. http://www.physiciansadvocacyinstitute.org/Portals/0/PAI-Physician-Employment-Study.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

MORTALITY TRENDS: Heart disease still leading cause of death but cancer is catching up

Heart disease is the leading cause of death in the U.S. and has been for decades.  In 2014, there were more than 614,000 deaths from heart disease.  However, a look at the long term trend lines shows that the number of deaths from heart disease is a curve that went up in the 70s and 80s  and then has been coming back down in more recent years.  The inflection point was 1985 with over 770,000 deaths from heart disease.

Cancer deaths meanwhile have been steadily increasing in a more or less straight line fashion from about 210,000 in 1950 to nearly 600,000 in 2014.  Cancer is the second leading cause of death and has now nearly caught up with heart disease.

As of the most recent year, 2014, there were 22 states in which cancer deaths have surpassed heart disease deaths.  The statisticians who wrote this brief note that the “leading-cause crossover” between heart disease and cancer was expected for the nation as a whole sometime around 2010, but that there was an uptick in heart disease mortality that kept this from happening at that time.

Source: Heron, M., and Anderson, R.N. (2016, Aug.). Changes in the leading cause of death: Recent patterns in heart disease and cancer mortality. NCHS Data Brief, 254.  Click here for free full text: http://www.cdc.gov/nchs/data/databriefs/db254.pdf   Also, data tables here: http://www.cdc.gov/nchs/data/databriefs/db254_table.pdf#1  Posted by AHA Resource Center (312) 422-2050, rc@aha.org