The Median Critical Access Hospital Needs to Reduce COPD Mortality by 1 per Year to get to the Top 90th Percentile

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Critical Access Hospitals (CAHs) are essential to the healthcare infrastructure, particularly in rural and remote areas. They often serve as the primary, and sometimes only, source of healthcare for their communities. One of the key performance indicators for these hospitals is the management of Chronic Obstructive Pulmonary Disease (COPD) mortality. This measure not only reflects the quality of care provided but also significantly influences the CMS Star Rating's mortality domain.

Dexur's analysis provides a crucial insight into the impact of small changes in COPD mortality rates at CAHs. According to the data, a reduction or increase in just one COPD mortality per year can dramatically shift a hospital's percentile ranking. Specifically, improving COPD Mortality measures by only one per year can elevate a hospital from the bottom 10th percentile to the top 90th percentile. Conversely, an increase in one mortality per year can result in a drastic decline from the top 90th percentile to the bottom 10th percentile.

Variable Value
Critical Access Hospitals (CAH) Analyzed 316
Index COPD Patients in 3 Years for the Largest Hospital 130
Index COPD Patients in 3 Years for the Smallest Hospital 25
Index COPD Patients in 3 Years for the Median Hospital 36
Impact of Reducing 1 Mortality/Year on COPD Mortality on Largest CAH Hospital 2.31%
Impact of Reducing 1 Mortality/Year on COPD Mortality on Median CAH Hospital 8.33%
National Average- COPD Mortality 8.4
Median - COPD Mortality 8.4
10th Percentile - COPD Mortality 9.9
90th Percentile - COPD Mortality 7.1
Difference Between Bottom 10th to Top 90th Percentile 2.8

This finding underscores a critical point: Critical Access Hospitals operate with a very narrow margin for error regarding COPD patient outcomes. The small patient base of these hospitals means that each patient's outcome significantly impacts the overall mortality rate. Therefore, it is imperative that every COPD patient receives meticulous attention, and their treatment plans are rigorously monitored and followed up.

In the context of the CMS Star Rating program, these findings take on added significance. The Star Rating system, used by the Centers for Medicare & Medicaid Services (CMS), evaluates healthcare providers on various performance measures, including mortality rates for specific conditions like COPD. Hospitals with better performance metrics receive higher star ratings, which can influence patient choice, reimbursement levels, and overall reputation.

For CAHs, where resources might be more limited compared to larger urban hospitals, excelling in these metrics is both a challenge and an opportunity. A focus on reducing COPD mortality by even a single case per year could result in significant quality improvements and better CMS Star Ratings. This achievement requires a concerted effort in patient care, including early detection, effective treatment protocols, patient education, and diligent follow-up care. Dexur’s Unified Quality, Risk and Incident Management software not only provides the tool to understand where to focus your efforts but also the platform to drive change for every single patient.