Hospitals in north rated by coalition

ALBANY — While one north country hospital — Claxton-Hepburn Medical Center in Ogdensburg — made the honor roll, the rest earned mostly average grades on an annual report card released Friday.

The 2008 New York State Hospital Report Card is compiled by the Niagara Health Quality Coalition, a nonprofit group seeking to improve health-care quality through information and transparency. This year's report card is the group's sixth statewide evaluation of hospitals.

"One way that patients can compare hospital quality is to ask where they have the best chance of surviving, and where they have the best chance of avoiding an infection or an error," said Bruce A. Boissonnault, the coalition's president and chief executive officer. "This report is the only way for patients, their families and communities to answer these questions objectively."

Using data collected from hospital reports to the state, the report card measures:

■ Risk-adjusted mortality rates under various procedures and conditions.

■ Patient safety information, including hospital infection rates.

■ Hospital volume by type of surgery.

■ Inappropriate procedure utilization rates.

■ Pediatric heart surgery mortality.

"Mortality rates are adjusted for how sick the patient is," Mr. Boissonnault explained. "We are careful not to discuss differences without a distinction. We want to be 95 percent sure that (the outcome) is not due to random chance."

As the largest hospital in Jefferson, Lewis and St. Lawrence counties, Samaritan Medical Center in Watertown received grades in the most areas. For 2007, the hospital was found to be "at the state average" in mortality from hip replacement, congestive heart failure, gastrointestinal hemorrhage, hip fracture, pneumonia and heart attack.

Samaritan rated "worse than the state average" in acute stroke mortality. In this category, the state's risk-adjusted mortality rate was 11 percent; the hospital treated 73 cases with a 30.4 percent risk-adjusted mortality rate.

Samaritan also was below average in mortality from heart attack, treating 33 cases with a risk-adjusted mortality rate of 13.8 percent. The state's risk-adjusted mortality rate was 7.6 percent.

Samaritan also was found to be "at the state average" in risk of collapsed lung, infections due to medical care and postoperative sepsis. Concerning potentially overused procedures, the hospital came in below the state average in Caesarean section deliveries, above average in vaginal births after Caesarean and average in appendectomies and incidental appendectomies in the elderly.

Carthage Area Hospital was rated average in congestive heart failure mortality, pneumonia mortality, risk of infections due to medical care, and risk of collapsed lung. Among potentially overused procedures, Carthage Area exceeded the state average in Caesarean section delivery and was at the state average in vaginal birth after Caesarean.

Gouverneur's E.J. Noble Hospital was rated average in risk of collapsed lung and risk of infections due to medical care. E.J. Noble came in at "worse than the state average" for mortality due to pneumonia. In 2007, the hospital treated 65 cases with a risk-adjusted mortality rate of 15.2 percent, while the state's risk-adjusted rate was 5.5 percent. The Gouverneur hospital was rated average in congestive heart failure mortality.

Lewis County General Hospital received average ratings in congestive heart failure mortality, pneumonia mortality and risks of collapsed lung, infections due to medical care and postoperative sepsis. The hospital was at the state utilization average in Caesarean section deliveries and below average in gall bladder removals.

Claxton-Hepburn Medical Center made the honor roll for performing at better than the state average in risk of infections due to medical care. The hospital had 3,114 cases with a 0.207 percent risk-occurrence rate. The state average was 0.221 percent. Claxton-Hepburn was the only area hospital named to the honor roll in any category.

The Ogdensburg hospital was in line with the state average for mortality due to congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture and pneumonia. It also received average ratings for risk of collapsed lung and risk of postoperative sepsis.

Canton-Potsdam Hospital, Potsdam, was at the state average for mortality from congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture and pneumonia. The hospital also received average grades for risk of collapsed lung, infections due to medical care and postoperative sepsis.

Massena Memorial Hospital earned average marks in risk-adjusted acute stroke mortality and gastrointestinal hemorrhage mortality, while coming in at "worse than the state average" for congestive heart failure mortality and pneumonia mortality.

In terms of patient safety, Massena Memorial was rated at average for risk of collapsed lung and below average for risk of infections due to medical care.

Clifton-Fine Hospital, Star Lake, was rated average for risk of collapsed lung and risk of infections due to medical care.

Hospitals did not receive ratings in areas where they did not perform enough procedures or surgeries from which to draw statistically viable conclusions.

"We urge patients and their families to do their homework in selecting a hospital and to discuss this information with their family physician before an emergency arises," Mr. Boissonnault said. "A hospital may be good at one area of care, but that doesn't mean that it's good in all areas."