Medical errors and suboptimal hospital conditions are a leading cause of death in the United States, resulting in hundreds of thousands of fatalities each year. Of course, some hospitals are worse than others, and the quality of care in a hospital depends largely on social and economic conditions where the facility is located.
A 2003 mandate requires the Centers for Medicare and Medicaid (CMS) to report several measures related to quality of care of hospitals across the United States in order to help Americans make more informed health decisions.
To determine the cities with the worst hospital care, 24/7 Wall St. created an index using data from the CMS and other sources. The index measures over a dozen indicators in three categories to assess the quality of hospital care in U.S. metro areas. The categories are mortality rate of patients within 30 days of admission, readmission rate within 30 days of discharge, and preventable hospitalizations.
To help ensure adverse outcomes are attributable to the hospitals rather than to factors related to the population the hospital serves, estimates of unplanned readmission and mortality are counted for patients only within 30 days of discharge.
Still, these indicators of hospital care quality can be very limited in scope. Variables such as patient frailty, the incidence and progression of chronic illnesses, and other factors may unfairly penalize some hospitals, especially those serving low-income populations. In fact, the median household income in all but one of the 25 cities with the worst-rated hospitals is lower than the national median of $57,617.