Study shows large gap in safety records of best and worst hospitals.

Hospital-acquired infection rates worsened by about 20 percent from 2000 to 2003, accounted for 9,552 deaths, and cost $2.6 billion dollars, according to a recent study of Medicare patients by HealthGrades, Inc., a Colorado-based company that rates health-care quality. Although overall mortality declined, patients experienced more medical errors and infections.

HealthGrades examined 13 possible medical incidents, called "patient safety indicators" (PSIs), in the medical records of Medicare patients over 65 admitted to 5,000 hospitals between 2001 and 2003. PSIs included blood clots, complications of anesthesia, hip fractures, failure to rescue, bedsores, and postoperative infection. Using the data, HealthGrades identified general trends about patient safety and analyzed medical incident rates for most U.S. hospitals.

A key finding was that hospitals with the best safety records (determined in a previous HealthGrades study) improved at a greater rate than those rated at the bottom; there were "wide gaps" between the safety records of hospitals in the top 10 percent and those in the bottom 10 percent. Overall, the hospitals with the lowest PSI incident rates (the top 10 percent of all hospitals studied) had 267,151 fewer patient safety incidents and 48,417 fewer deaths than those in the bottom 10 percent.

"The reason we see the hospitals with the lowest incident rates improving the fastest is that they have what I call a 'culture of safety,'" said Samantha Collier, a physician and vice president of medical affairs for HealthGrades, in a press release issued by the company. Collier, who wrote the study, said it shows that patients are, "on average, 50 percent less likely to have an incident at hospitals in the HealthGrades top 10 percent, according to the HealthGrades study."

The study is based on objective data that hospitals report to the federal government, said Scott Shapiro, a HealthGrades spokesman. Data was adjusted so that hospitals with "sicker patient populations" could be compared with others.

HealthGrades is a public, for-profit company that evaluates the quality of hospitals, physicians, and nursing homes and sells its reports to consumers, hospitals, and insurance underwriters. Corporations and health plans also can purchase customized versions of the company's Web site to help employees or members choose health care providers. The HealthGrades Patient Safety in American Hospitals Study (2005) and other reports are available at www.healthgrades.com.