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Heart attack survival at LBJ 5% better than in US

Heart failure survival rates not so good
fili@samoanews.com

For 2010 the national 30-day mortality rate in mainland hospitals for heart attacks was 16%. At LBJ it was under 11% - according to LBJ Medical Center chief executive officer Mike Gerstenberger who said, statistically, your chance of surviving is 5% better, if you were treated at LBJ then if you were treated anywhere on the mainland. But he also said that for heart failure it is an entirely different story.

Wiki Answers explains the difference between the two heart diagnoses: A heart attack happens when heart muscle cells do not get enough blood. Heart failure happens when the heart is too weak to pump enough blood to meet the body's needs.

Gerstenberger revealed these statistics at last week Friday’s public hearing on the proposed new rate hikes and said the hospital is now participating in a federal Medicare survey, which measures the quality of care provided by LBJ .  “We are now measuring the quality of care” at LBJ and this is “a requirement of Medicare,” he said adding that under this assessment, LBJ looks at - “did the patient live or die; was the patient re-admitted for the same problem 30 days after being discharged.”

He said LBJ also reviews diagnosis and specific issues that should always occur or never occur and also looks at patient satisfaction.

“...so even if we do all of the technical things correct, [but] if the patient feels they had a bad experience, then we delivered poor quality care,” said Gerstenberger, who explained that Medicare has six outcome measures and the first one is 30-day mortality.

“...that means either the patient died in the hospital, or within 30 days after being discharged from the hospital for three diagnosis: heart attack, heart failure or pneumonia,” he said, pointing out that the US 30-day mortality rate for heart attacks is 16% while at LBJ it was under 11%.

“For heart failure - it's a little different story. The average in the states is about 11% mortality for heart failure. In American Samoa its almost 19%,” he said. “We are spending time now to figure out our weakness - are we doing something different, or are our patients different. Why is the heart failure rate so much higher here?”

“Unfortunately part of the problem being in a place where there is relatively a small population, it takes a long time, to amass enough cases that you can make statistical conclusions. So we are still looking at heart failures,” he said.

For pneumonia, the 30-day mortality rate in the US is just under 12% and LBJ is exactly at that number, said Gerstenberger.

The three other measures deal with the 30-day re-admission rates for the same diagnosis of heart attack, heart failure and pneumonia. He said these measures show whether LBJ discharged a patient too quickly or the patient was not treated adequately.  He added that LBJ’s readmission rates “are a fraction” of the national average.

“In five out of the six outcome measures, in the quality of care at LBJ,  LBJ scored ‘as well or better’ than all the other hospitals in the country,” he said. “But that is not the presumption that you hear out there [in the community].”



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