By: James Pitt  Jun. 11, 2018
Dexur analysts compared the 20 hospitals with the most CMS inpatient discharges for DRGs 001 and 002 from 2013 to 2016. The national average in-hospital mortality rate for DRG 001 patients was 11.94% from January 2013 to December 2016. St. Luke’s in-hospital mortality rate for these patients was 13% in this period, a 1% difference from national average. The other top 20 hospitals also average slightly higher mortality rates than the national average. The highest was 18% at Stanford Health Care (Stanford, CA), and the lowest 7% at Duke University Health System (Durham, NC).
Some hospitals have riskier patients than others. A simple way to compare risks is case mix index. Medicare groups heart transplants and related procedures such as ventricular assist device (VAD) implantation in diagnosis-related group 001 for patients with major complications or comorbidities, and DRG 002 for patients without major complications or comorbidities. A hospital with a high ratio of DRG 001 to DRG 002 patients most likely has sicker heart transplant patients than a hospital with a low ratio of DRG 001 to DRG 002.
Nationally, 87% of Heart Transplant or Implant of Heart Assist System patients are in DRG 001. (13% are in DRG 002). At the top 20 hospitals for these procedures, 90% of patients are DRG 001. At St. Luke’s, 92% are in DRG 001. Therefore, St. Luke’s appears to indeed have somewhat sicker heart transplant patients, compared to the national average and to other large heart transplant hospitals. Among the hospitals that performed the most heart transplants, the highest proportion of DRG 001 patients was 99% at Spectrum Health Butterworth Hospital (Grand Rapids, MI). The lowest proportion was 77%, at Baptist Health Medical Center-Little Rock (Little Rock, AR).
From 2013-2016, including national data and data for the below hospitals: